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P0373 Factors Associated with a Complicated Behavior or Diagnostic Delay in Crohn’s Disease: A Prospective Multicenter French and Belgian Cohort of Newly Diagnosed Patients
No full textInternational audienceBackground Despite diagnostic advances, one-third of Crohn’s disease (CD) patients still present with complicated behavior at diagnosis. Delayed diagnosis, often related to nonspecific symptoms or socio-demographic factors, may contribute to this 1. We aimed to identify factors linked to delayed diagnosis or complicated CD. Methods We conducted a prospective multicenter observational study in France and Belgium (April 2024 - December 2025) including consecutive CD patients (≥18 years) diagnosed within the last 12 months. Patients and gastroenterologists completed questionnaires on clinical, socio-demographic, socio-economic deprivation assessed by the EPICES score (French individual index of deprivation), and healthcare pathway data. Late diagnosis was defined as > 12 months from symptom onset. Univariate analyses compared inflammatory (B1) vs complicated (Stricturing = B2/ Fistulizing = B3) behavior and delayed (>12 months) vs timely (<12 months) diagnosis. Multivariate analyses will follow. Results Across 61 centers, 743 patients were enrolled. We present findings from the first 316 included. Forty-nine percent were female; median age was 30 years [23–43]. Disease location was ileal (48%), colonic (18%), or ileocolonic (34%). At diagnosis, 63% had B1 and 37% B2/B3 behavior; 24% had a delayed diagnosis. Complicated CD was more frequent in male patients (61% vs 46%;p = 0.010), in case of ileal location (58% vs 42%; p = 0.010) and hospitalization at diagnosis (71% vs 44%;p<0.001). B1 behavior was more common in female patients (54% vs 39%; p = 0,010), patients having children (46% vs 33%;p = 0.033), family history of IBD (27% vs 16%; p = 0.037), and was associated with misdiagnosis (44% vs 32%;p = 0.,030), ≥3 General Practitioners (GP) consultations prior to diagnosis (45% vs 24%;p<0.,001), diarrhea (42% vs 12%;p<0.001) and presence of at least one red flag (nocturnal diarrhea, prolonged diarrhea, rectal bleeding, or weight loss) (93% vs 74%; p < 0.001). Diagnostic delay was associated with ≥3 GP consults (59% vs 31%;p<0.001), misdiagnosis (64% vs 32%;p<0.001), >4-week wait for gastroenterologist visit (58% vs 35%; p < 0.001), and use of complementary medicine (38% vs 21%;p<0.007). No association was found with gender, age, red flags, EPICES score and disease location or behavior. Conclusion In this large cohort of CD patients, B1 forms seemed to be initially misdiagnosed for irritable bowel syndrome-diarrhea, leading to a prolonged diagnostic journey before gastroenterology referral, whereas complicated forms (B2/B3) may have evolved silently before presenting with abrupt and severe manifestations prompting immediate evaluation. Diagnostic delays were mainly driven by factors related to the healthcare pathway rather than by deprivation or disease behavior. Reference: 1. Souaid C, Fares E, Primard P, Macaigne G, El Hajj W, Nahon S. A review investigating delays in Crohn’s disease diagnosis. Clin Res Hepatol Gastroenterol. 2025;49(1):102500. doi:10.1016/j.clinre.2024.102500 Conflict of interest: Dr. Souaid, Christophe: No conflict of interest Flamant, Mathurin: No conflict of interest Bozon, Anne: No conflict of interest Nancey, Stéphane: board membership and lecturing fees from Abbvie, Takeda, Celltrion Healthcare, Pfizer, Galapagos, Johnson & Jonshon, Lilly, Fresenius, Amgen, Medac, MSD. Caron, Bénédicte: No conflict of interest Blanc, Pierre: No conflict of interest Buisson, Anthony: Grant: Abbvie, Celltrion, Pfizer and Takeda Personal Fees: Abbvie, Amgen, Arena, Biogen, Celltrion, Ferring, Janssen, MSD, Pfizer, Roche, Sanofi-Aventis, Takeda, Tillotts, Vifor Pharma, Richard, Nicolas: Lecture/consultant fees from AbbVie, Amgen, Celltrion, Ferring, Janssen, Lilly, Sandoz and Takeda. Barrau, Mathilde: No conflict of interest Faure, Patrick: No conflict of interest Nachury, Maria: Abbvie, Alfa Sigma, Biosynex, Celltrion, Galapagos, Janssen, Lilly, MSD, Pfizer, Takeda Allez, Matthieu: Grant: Janssen, Genentech/Roche, Takeda Personal Fees: Abbvie, Amgen, Astra-Zeneca, Biogen, Boehringer-Ingelheim, Bristol Myers Squibb, Celgene, Celltrion, Ferring, Galapagos, Genentech, Gilead, IQVIA, Janssen, Novartis, Pfizer, Spyre therapeutics, Roche, Takeda, Tillots Fumery, Mathurin: Grant: Pfizer Personal Fees: Abbvie, Janssen, Takeda, MSD, Biogen, Amgen, Sandoz, Fresenius, Gilead, Celgene, Galapagos, Mylan, Tillots, Ferring, Pfizer, Hospira, CTMA, Boehringer, Lilly, Arena Non-financial Support: Abbvie, Janssen, Takeda, MSD, Galapagos, Ferring, Pfizer Mathieu, Nicolas: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: Abbvie, Alfa sigma,Biosynex, Celltrion, Janssen, Lilly, Pfizer, Takeda: Speakers fees payments Support for attending meetings and/or travel: Abbvie, Celltrion, Janssen, Lilly, Pfizer, Takeda Participation on a Data Safety Monitoring Board or Advisory Board: Abbvie, Alfa sigma, Celltrion, Janssen, Lilly, Medtronic, Pfizer, Takeda Clairet, Valentine: No conflict of interest Charkaoui, Maeva: No conflict of interest Caillo, Ludovic: Abbvie, Amgen, Celltrion, Ferring, Fresenius, Lilly, Jonhson&Jonhson, MSD, Pfizer, Takeda, Sandoz Laharie, David: Personal Fees: Board, consulting and lecture fees from Abbvie, Alfasigma, Amgen, Biocon, Celltrion, Ferring, Fresenius-Kabi, Johnson & Johnson, Lilly, MSD, Pfizer, Sandoz and Takeda Uzzan, Mathieu: Grant: ECCO-IOIBD, Fondation pour la Recherche Medicale (FRM), SNFGE Personal Fees: Abbvie, Takeda, Celltrion, Janssen, Amgen, Alfasigma, Pfizer Etienney, Isabelle: takeda Locher, Christophe: No conflict of interest Guillo, Lucas: No conflict of interest Reenaers, Catherine: Grant: Ferring, Janssen, Takeda, Fresenius, Biogen Personal Fees: Ferring, Janssen, Takeda, Fresenius, Abbvie, Galapagos, Pfizer, Celltrion, Thermofisher, BMS, Lilly, Thermofisher Nuzzo, Alexandre: No conflict of interest Vidon, Mathias: No conflict of interest Gouynou, Célia: No conflict of interest Kirchgesner, Julien: Lecture fees and/or consulting fees from from Abbvie, Amgen, Astrazeneca, Celltrion, Galapagos, Janssen, Lilly, MSD, Takeda, Tillots, Pfizer. Viennot, Stéphanie: No conflict of interest Pelletier, Anne-Laure: received lecture/consultant fees from Janssen,Pfizer and Novartis Liefferinckx, Claire: Consultancy/speaker fees: Takeda, Janssen, Abbvie, Alfasigma, Celltrion Le Gall, Guillaume: No conflict of interest Paupard, Thierry: No conflict of interest Cavicchi, Maryan Nicolas: M.C.: Consultant for JOHNSON & JOHNSON, ABBVIE, TAKEDA and MSD Honoraria for lectures, presentations, speakers for MSD, LILLY, ABBVIE, AMGEN, TAKEDA, PFIZER, MYLAN and TILLOTS Support for attending meetings from JOHNSON & JOHNSON, ABBVIE, FERRING, TAKEDA and MSD Board for JOHNSON & JOHNSON, ABBVIE, PFIZER and LILLY Receipt of equipment and materials from CELTRION and BIOSYNEX Fathallah, Nadia: Grant: A. Legrand AbbVie Amgen Biolitec Brothier FCare Systems Janssen Sandoz Takeda THD Lab Tillotts Pharma Favier, Laurie: No conflict of interest Skinazi, Florence: No conflict of interest Le Berre, Catherine: Abbvie, Amgen, Celltrion, Ferring, Fresenius Kabi, Galapagos, Gielad, Janssen, Lilly, MSD, Nordic Pharma, Pfizer, Sandoz, Takeda. Del Tedesco, Emilie: Abbvie, Sanofi, Ferring, Pfizer, Janssen, Takeda, Mylan, Viatris, Norgine, Lilly, Biogen, Mayoly,Gilead, Amgen et Celltrion Renaud, Laurence: No conflict of interest Nahon, Stéphane: No conflict of interes
Two epigenetic markers of the fibromyalgia syndrome: A matched case-control study
No full textInternational audienceMicroRNAs (miRs) are involved in regulating various biological processes and may contribute to the pathophysiology of fibromyalgia syndrome (FMS). In order to explore correlations with clinical characteristics and to identify specific clusters, we performed plasma miR sequencing in 113 FMS patients diagnosed on ACR 2016 criteria and in 29 healthy volunteers (HV). All FMS patients were women, an important point as sex differences in FMS and immune regulation are well-documented. Subgrouping of FMS patients identified two distinct molecular clusters (FM1 and FM2), with FM1 showing significant miR dysregulation, compared to HV. Clinically, FM1 and FM2 did not differ in terms of age, disease severity, pain score, or quality of life. In parallel, the miRs analysis of clinical clusters ("severe", "intermediate" and "mild" FM) showed two significantly dysregulated miRs: miR-4771 and miR-2115-3p, and both correlated with the "impact on functioning" score of the Brief Pain Inventory questionnaire. Bioinformatics analysis suggested that both miRs may be involved in the TGF-beta signalling pathway, potentially linking neuroimmune dysregulation with symptom severity. Given that this study focuses on women patients, future research should address whether these findings are applicable to men or in mixed-sex populations, which could enhance the generalizability of the results. This study highlights the epigenetic heterogeneity of FMS, and suggests that two miRs could serve as potential biomarkers for disease stratification, and targets for personalized therapies. Future studies are needed to validate these findings and to explore their clinical potential. Perspective: Using high-throughput sequencing of plasma miRNAs, this study identifies two miRs associated with FMS severity and reveals distinct molecular subgroups. These findings highlight the biological heterogeneity of FMS and may inform future biomarker-based approaches to diagnosis and therapy
Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group
No full textInternational audienceNumerous publications have questioned the lack of analytical reliability and clinical relevance of sperm morphology assessment for infertility workup and before use of assisted reproductive techniques (ART). There is a huge variability in the performance and interpretation of this test. It has become necessary to evaluate its true medical service rendered to the patient. Objectives To develop clinical guidelines for use of spermatozoa morphology assessment during male fertility check‐up and before ART. Materials and Methods These guidelines were produced following a pre‐defined standard methodology for narrative and Patient Intervention Comparison Outcomes (PICO) questions. The French Working Group (WG) on Sperm Morphology Assessment consisted of 15 members including an expert in statistics. Results R1: WG does not recommend systematic detailed analysis of abnormalities (or groups of abnormalities) during sperm morphology assessment. R2: WG recommends that the laboratory should use a qualitative or quantitative method for detection of a monomorphic abnormality (globozoospermia, macrocephalic spermatozoa syndrome, pinhead spermatozoa syndrome, multiple flagellar abnormalities). The result may be given as an interpretative commentary or as a numerical report of the percentage of detailed abnormalities. R3: There is insufficient evidence to demonstrate the clinical value of indexes of multiple sperm defects (TZI, SDI, MAI) in investigation of infertility and before ART. Accordingly, the working group does not recommend the use of sperm abnormality indexes (TZI, SDI, MAI) in sperm morphology assessment. R4: WG gives a positive opinion on the use of automated systems based on cytological analysis after staining after qualification of the operators, and validation of the analytical performance within their own laboratory. R5: WG does not recommend using the percentage of spermatozoa with normal morphology as a prognostic criterion before IUI, IVF, or ICSI, or as a tool for selecting the ART procedure. Discussion This article examines the clinical interest of sperm morphology assessment during fertility check‐up and before ART. The overall level of evidence from studies is low, challenging current practices regarding sperm morphology assessment. Conclusion These guidelines suggest a significant simplification of sperm morphology assessment in the light of the examined publications while maintaining the detection of monomorphic sperm abnormalities
Influence of Time Interval Between the Two Stages of Delayed Coloanal Anastomosis on the Risk of Anastomotic Leakage: Multicenter Study from the GRECCAR Group
No full textInternational audienceBACKGROUND: The optimal time interval between the two surgical stages of a delayed coloanal anastomosis has never been investigated. OBJECTIVE: Assess the influence of time interval on anastomotic leakage occurrence DESIGN: Retrospective cohort study. SETTINGS: Multicentric study (30 colorectal centers). PATIENTS: All patients who underwent delayed coloanal anastomosis (2010-2021). MAIN OUTCOME MEASURES: anastomotic leakage in relation to the time interval between the two surgical stages. RESULTS: A total of 506 patients (female: 42%, median age: 62.1 years) underwent delayed colo-anal anastomosis, 63% immediately after a low anterior resection (primary delayed coloanal anastomosis) and 37% after failure of primary pelvic surgery as a salvage procedure (salvage delayed coloanal anastomosis). The main reasons for salvage delayed coloanal anastomosis were chronic pelvic sepsis (42%) and rectovaginal fistula (38%). The mean time interval between two stages was 8.6 ± 3.8 days, ranging from 1 to 22 days. In the entire cohort, the incidence of anastomotic leakage was 18% (89/506, 95 CI [14%, 21%]) and time interval did not affect the occurrence of anastomotic leakage ( p = 0.529). In sub-group analysis, anastomotic leakage risk was not associated with time interval among primary delayed coloanal anastomosis patients ( p = 0.579) whereas it was for salvage delayed coloanal anastomosis patients ( p = 0.013). In salvage delayed coloanal anastomosis patients, multivariate analysis showed that a longer time interval (adjusted OR=0.89, 95 CI [0.81-0.98], p = 0.035) and surgery in centers performing ≥4 delayed coloanal anastomosis per year (adjusted OR = 0.07, 95 CI [0.01-0.36], p = 0.011) were significantly linked to a lower risk of anastomotic leakage. Each additional day between the two salvage delayed coloanal anastomosis procedures was estimated to reduce the risk of anastomotic leakage by 11%. LIMITATIONS: The retrospective design. CONCLUSIONS: In the context of primary delayed coloanal anastomosis, increasing the time interval between the two stages of delayed coloanal anastomosis does not influence the risk of anastomotic leakage. For salvage delayed coloanal anastomosis, extending the time interval significantly reduces the risk of anastomotic leakage.Multicentric study (30 colorectal centers)
Target trial emulation to replicate randomised clinical trials using registry data in multiple sclerosis
No full textInternational audienceBackground: Target trial emulation (TTE) offers a formal framework for causal inference using observational data, but its validity must be evaluated in each research domain by replicating randomised clinical trials (RCTs). We aimed to replicate eight RCTs evaluating the efficacy of disease-modifying therapies (DMTs) in multiple sclerosis (MS) using French registry data.Methods: This multicentre, retrospective, observational study was conducted using data extracted in December 2023 from the Observatoire Français de la Sclérose en Plaques (OFSEP) database. For each emulated trial, patients were included when they initiated one of the DMT evaluated in the corresponding RCT and met its inclusion criteria. Clinical outcomes were the annualised relapse rate and 3-month confirmed Expanded Disability Status Scale progression. Radiological outcomes were new/enlarged T2-lesions and new gadolinium-enhanced T1-lesions on a brain MRI. A targeted maximum likelihood estimator was used to estimate the treatment effect adjusted for confounding factors between groups and corrected for censoring and missing outcome assessment.Results: 14 111 patients were included in eight emulated trials: ASSESS (fingolimod vs glatiramer acetate), BEYOND (interferon beta vs glatiramer acetate), CONFIRM (dimethyl fumarate (DMF) vs glatiramer acetate), OPERA (ocrelizumab vs interferon beta), REGARD (interferon beta vs glatiramer acetate), RIFUND-MS (rituximab vs DMF), TENERE (teriflunomide vs interferon beta) and TRANSFORMS (fingolimod vs interferon beta). Treatment effects estimated in emulated trials were concordant with RCT findings in seven of eight trials for relapse rate, and in all six trials assessing disability progression. Radiological outcomes were more challenging to replicate; concordance was achieved in three of five trials for new T2-lesions, and one of four trials for new gadolinium-enhanced T1-lesions.Conclusion: The combined use of a TTE methodology and high-quality registry data is a valid tool to evaluate treatment effectiveness in MS
Chronic graft-versus-host disease in long-term survivors of childhood leukemia
No full textInternational audienceHematopoietic stem cell transplantation (HSCT) is a curative treatment for high-risk childhood leukemia but may lead to chronic graft-versus-host disease (cGvHD), a severe long-term complication. This study analyzed data from the LEA cohort, including 446 childhood leukemia survivors treated with allogeneic HSCT. The standardized cGvHD evaluation, using the NIH consensus criteria, was conducted 8.7 ± 0.3 years post-HSCT. Long-term cGvHD was reported in 21% of patients (9% mild, 7% moderate, 5% severe), primarily affecting eyes, skin, lungs, and mouth, with some cases involving multiple organs. Most patients with long-term cGvHD were untreated (84%), while 11% received systemic and 5% local treatments. cGvHD was associated with other long-term complications. Administration of anti-thymocyte globulin was a significant determinant (OR 0.6, 95% CI 0.4-0.99, P = 0.045). Long-term cGvHD showed a marked detrimental effect on the quality of life (QoL), even after adjusting for the other long-term complications. The SF-36 physical and psychological adjusted composite scores in patients with versus without cGvHD were 50 ± 2 versus 55 ± 1 (P = 0.01) and 38 ± 2 versus 43 ± 1 (P = 0.01), respectively. Even mild and moderate forms significantly affected the QoL, especially on psychological dimensions. These findings support standardized cGvHD evaluation and management to improve long-term outcomes of transplanted childhood leukemia survivors
Évaluation de l’impact de la thérapie manuelle dans la prise en charge des lombalgies non spécifiques : revue de la portée des critères utilisés dans les essais cliniques
No full textInternational audienceBackground: Low Back Pain (LBP) is the leading cause of disability worldwide, 90% of which is nonspecific. Manual therapy is one of the recommended treatment modalities. However, reported outcomes may be variable. This review aims to identify their scope in the context of the development of a Core Outcome Set (COS), which is defined as « an agreed standardised set of outcomes that should be measured and reported, as a minimum, in all clinical trials in specific areas of health or health care ».Methods: A scoping review with risk of bias assessment of randomised controlled trials (RCTs) of manual therapy for nonspecific LBP was conducted using MEDLINE, CENTRAL, PEDro, WebOfScience and ClinicalTrials.gov, from 2010 up to August 2024. Manual therapy was considered the use, alone or in combination, of manipulations (high velocity, low amplitude), mobilisations (low-grade velocity, small-to-large amplitude) or soft tissue relaxation (especially massage, trigger points, muscle contractions).Results: Out of 3929 articles, 147 RCTs and 74 protocols were included. Two main outcomes emerged: pain intensity (assessed by numerical rating scale or visual analogue scale) and disability (mostly assessed by Rolland-Morris Disability Questionnaire or Oswestry Disability Index). Range of motion is the most frequent clinical outcome assessed. Psychological factors such as fear-avoidance beliefs, kinesiophobia and catastrophising, and healthcare consumption, particularly medication, are also frequent. Most of the outcomes were patient-reported outcomes.Conclusion: Consistent with a previous COS on nonspecific low back pain, manual therapy appears to address the same outcomes. Clinical trials in manual therapy should focus on using the existing COS by measuring pain intensity using a numerical rating scale, disability using the ODI 2.1a or the 24-item RMDQ, health-related quality of life using the SF-12 or the 10-item PROMIS. Additionally, due to the gap between clinical research and pain experience, trials should consider conducting subgroup analyses to identify effects on outcomes related to gender or age, paying particular attention to health inequalities by carrying out analyses based on socioeconomic status, as these factors are well known to significantly impact pain experience and access to care.Review protocol: PROSPERO registration CRD42024576475, COMET Database registration 3229.Introduction : La lombalgie est la principale cause d’incapacité dans le monde, jusqu’à 95% étant non spécifiques. La thérapie manuelle est l’une des modalités de traitement recommandées. Cependant, les critères de jugement utilisés peuvent être variables. Cette revue vise à développer un Core Outcome Set (COS), défini comme “un ensemble standardisé de critères devant être mesurés et rapportés, au minimum, dans tous les essais cliniques dans des domaines spécifiques de la santé ou des soins de santé”, pour la prise en charge des lombalgies non spécifiques en thérapie manuelle.Méthodes : Une revue de la portée avec analyse du risque de biais d’essais contrôlés randomisés (ECR) sur la prise en charge en thérapie manuelle des lombalgies non spécifiques a été menée sur MEDLINE, CENTRAL, PEDro, WebOfScience et ClinicalTrials.gov, de 2010 à août 2024. La thérapie manuelle incluait manipulations (haute vélocité, faible amplitude), mobilisations (faible vélocité, faible à grande amplitude) et relaxation des tissus mous (massages, points gâchettes, contractions musculaires).Résultats : Sur 3 929 articles, 147 ECR et 74 protocoles ont été inclus. Deux critères principaux ont émergé : l’intensité de la douleur (échelle numérique ou visuelle analogique) et l’incapacité (Rolland Morris Disability Questionnaire (RMDQ) ou Oswestry Disability Index (ODI). L’amplitude des mouvements était le résultat clinique le plus fréquent. Les facteurs psychologiques (croyances de peur-évitement, kinésiophobie, catastrophisme) et la consommation de soins de santé (médicaments) étaient aussi régulièrement rapportés. La plupart des résultats étaient des résultats rapportés par les patients.Conclusion : Les critères identifiés concordent avec le COS préexistant pour les lombalgies non spécifiques. Les essais cliniques doivent mesurer la douleur via une échelle numérique, l’incapacité par l’ODI 2.1a ou le RMDQ-24, et la qualité de vie par le SF-12 ou le PROMIS-10. La réalisation d’analyses de sous-groupes basées sur le genre, l’âge et le statut socio-économique est préconisée pour intégrer les inégalités de santé et la variabilité de l’expérience de la douleur.Enregistrement du protocole : PROSPERO CRD42024576475, Base de données COMET 3229
P1107 Comparison of effectiveness between ustekinumab and upadacitinib in patients with ulcerative colitis previously exposed to at least one anti-TNF agent: results from the real-world evidence multicenter UPPERCUT study
No full textInternational audienceBackground We compared the effectiveness of ustekinumab (UST) and upadacitinib (UPA) in patients with ulcerative colitis (UC) previously exposed to at least one anti-TNF agent. Methods This was a multicenter retrospective study that consecutively included all patients aged ≥18 years-old with symptomatic UC (partial Mayo score >2) who initiated UST or UPA after exposure to at least one anti-TNF. UST was initiated with an intravenous infusion followed by SC injections of 90 mg every 8 weeks, with the option of intensification to 90 mg every 4 weeks from week 4 at the clinician’s discretion. UPA was prescribed at 45 mg once daily for 8 weeks, followed by 45 mg, 30 mg, or 15 mg at the physician’s discretion. The primary endpoint was symptomatic remission (partial Mayo score ≤2) without corticosteroids (CFREM) at week 16 (W16). Secondary endpoints were clinical remission per modified Mayo score, and histological and endoscopic improvement (HEMI). Comparisons were made using propensity-score analyses adjusted on the usual potential confounders. Results A total of 226 patients were included (165 and 61 in UST and UPA groups, respectively). Except for higher proportion of prior exposure to more than two biologics (46.6% vs 82.0%; p < 0.001) in UPA group, the populations were comparable (UST vs UPA). After propensity score adjustment, CFREM at W16 was 35.1% and 37.2% in UST and UPA groups, respectively (p = 0.91). Subgroup analyses (after propensity adjustment) did not show any difference in CFREM at W16 after failure to only one biologic, whereas UPA was significantly more effective than UST (OR = 6.05 [1.10–33.42]; p = 0.039), after exposure to ≥ 2 advanced therapies, as well as in patients with primary failure to ≥ 2 prior biologics (OR = 4.25 [1.11–16.28]; p = 0.035). However, no difference was observed between the two treatments according to UC severity. No predictor of UPA effectiveness was identified. Factors associated with absence of CFREM at W16 under UST were: failure of ≥ 3 biologics (p = 0.013) and primary failure to at least one biologic (p = 0.013). No difference was observed between the two treatments regarding clinical remission and HEMI (p = 0.48 and 0.68, respectively). After a median follow-up > 12 months, we did not see any difference regarding treatment discontinuation, UC-related hospitalization, or colectomy. Conclusion In this study, UST and UPA appeared to have comparable effectiveness in the overall population of UC patients previously exposed to at least one anti-TNF. However, UPA was more effective than UST in patients exposed to at least two biologics and/or with at least two prior primary failures. These results may help physicians to personalize therapeutic decision-making in UC. Conflict of interest: Prof. Dr. Buisson, Anthony: Consulting fees from: Abbvie, AlfaSigma, Amgen, Arena, Biogen, Celltrion, CTMA, Ferring, Galapagos, Guty Care, Janssen, Hikma, Lilly, Mylan, Nexbiome, Pfizer, Roche, Takeda, Tillotts Lecture fees from: Abbvie, AlfaSigma, Amgen, Biogen, Celltrion, Ferring, Galapagos, Hikma, Janssen, Lilly, Mayoli-Spindler, MSD, Pfizer, Roche, Sanofi-Aventis, Takeda, Tillotts, Vifor-Pharma Research fundings from: Abbvie, AlfaSigma, Celltrion, Janssen, Lessaffre, Lilly, Pfizer, Takeda Serrero, Melanie: fees from Pfizer, Abbvie, Takeda, Janssen, MSD, Amgen, Ferring, Tillotts, Celltrion Altwegg, Romain: Advisory boards from Abbvie, Takeda, Johnson and Johnson, Lilly, Alphasigma, Celltrion, Pfizer, Amgen, Biogen, Sandoz, Ferring Vuitton, Lucine: No conflict of interest Uzzan, Mathieu: Grant: ECCO-IOIBD, Fondation pour la Recherche Medicale (FRM), SNFGE Personal Fees: Abbvie, Takeda, Celltrion, Janssen, Amgen, Alfasigma, Pfizer Domas, Quentin: No conflict of interest Tretón, Xavier: Personal Fees: Lectures and advisory board : Abbvie, Celltrion, MSD, johnson&Johnson, Takeda, Amgen, Alphasigma, Lilly, Pfizer Other: participations: Thabor Therapeutics Nachury, Maria: Abbvie, Alfa Sigma, Biosynex, Celltrion, Galapagos, Janssen, Lilly, MSD, Pfizer, Takeda Amiot, Aurelien: Personal Fees: Abbvie, Fresenius-Kabi, Adacyte, Tillotts pharma, Janssen, Pfizer, Biogen, AMgen, Sandoz, Takeda, Galapagos, Eli Lilly Caillo, Ludovic: Abbvie, Amgen, Celltrion, Ferring, Fresenius, Lilly, Jonhson&Jonhson, MSD, Pfizer, Takeda, Sandoz Hupé, Marianne: No conflict of interest Pereira, Bruno: No conflict of interest Fumery, Mathurin: Grant: Pfizer Personal Fees: Abbvie, Janssen, Takeda, MSD, Biogen, Amgen, Sandoz, Fresenius, Gilead, Celgene, Galapagos, Mylan, Tillots, Ferring, Pfizer, Hospira, CTMA, Boehringer, Lilly, Arena Non-financial Support: Abbvie, Janssen, Takeda, MSD, Galapagos, Ferring, Pfize
Cystite érosive associée à un usage chronique de kétamine: à propos d’un cas
No full textInternational audienc
Association Between Metabolic Syndrome, Obesity, and Cognitive Performances in Individuals With Bipolar Disorders: Cross‐Sectional and Longitudinal Analyses in the FACE ‐ BD Cohort
No full textInternational audienceIntroduction: Metabolic syndrome (MetS) has been suggested to be associated with cognitive impairments in bipolar disorder (BD); however, studies are limited by small sample sizes or cross-sectional design. Our objective is to evaluate the cross-sectional and longitudinal associations between MetS and cognitive performances in a large cohort of individuals with BD.Methods: 1175 individuals with a DSM-IV diagnosis of BD were included from the FACE-BD cohort, assessed with a standardized battery of clinical and neuropsychological tests and followed up with a cognitive retest at 2 years for a subsample (n = 367). A global cognitive index was created by using a Principal Component Analysis. Associations between MetS and cognitive performances at baseline were explored using multiple analyses of covariance and linear mixed models were used for longitudinal data.Results: The prevalence of MetS was 21.5% in this sample. Multivariable analyses identified associations between MetS and poorer cognitive performance in the cross-sectional analysis, independently of age, gender, education level, psychotropic treatments, and comorbidities. Specifically, individuals with MetS showed poorer results (global cognitive index, cognitive flexibility, inhibition, and verbal memory). After adjustment, the longitudinal analysis showed no change in the global cognitive index at year 2 and no time × metabolic syndrome interaction.Conclusions: Our results suggest that MetS is cross-sectionally, but not longitudinally, associated with poorer cognitive performances in BD. This study highlights the importance of systematically and accurately screening for metabolic abnormalities in individuals with BD, and screening for cognitive deficit especially in individuals with MetS. Our results suggest that MetS is not a risk factor for cognitive decline during the follow-up, but further longitudinal studies are required