January 2025
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46 Reads
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2 Citations
The Lancet Rheumatology
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January 2025
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46 Reads
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2 Citations
The Lancet Rheumatology
January 2025
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73 Reads
January 2025
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6 Reads
Revue des Maladies Respiratoires Actualités
December 2024
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13 Reads
BJOG An International Journal of Obstetrics & Gynaecology
Objective To assess safety of fertility treatments in women with systemic lupus erythematosus (SLE). Design Data from the multicentre French observational GR2 (Groupe de Recherche sur la Grossesse et les Maladies Rares) study (2014‐ongoing). Setting Seventy‐six centres in France. Population All pregnancies in women with SLE enrolled in the GR2 study, conceived before 1 August 2022, with available end‐of‐pregnancy data and known conception type, were included; that is, 577 spontaneous and 53 assisted pregnancies. Methods A comparative analysis of spontaneous and assisted pregnancies was conducted. Logistic regression was used to determine if fertility treatments were independently associated with live birth prognosis, adjusting for confounders (e.g., maternal age). Kaplan–Meier analysis compared cumulative incidences of disease flares and adverse pregnancy outcomes (APOs), with confounding factors adjusted using a Cox regression model. Main Outcome Measures Live birth, disease flares, and APOs. Results The mean age was older (35.8 vs. 32.3 years, p < 1 × 10⁻⁴), and twins were more frequent in assisted pregnancies (5/50, 10.0% vs. 20/554, 3.6%; p = 0.047). Lupus disease was clinically inactive at baseline in 51 (96.2%) assisted pregnancies (vs. n = 511, 89.6%; p = 0.15), with 35 of 45 (77.8%) having no chronic damage (vs. 448/513, 87.3%; p = 0.07). The live birth rate was similar between assisted and spontaneous pregnancies (n = 46, 86.8% vs. n = 505, 87.5%; p = 0.83), with no statistical difference in the incidence of lupus flares and APOs. These results remained consistent after adjusting for confounding factors. Conclusions Fertility treatments in women with mostly well‐controlled SLE did not appear to increase risks of maternal and neonatal complications, supporting current recommendations. Trial Registration ClinicalTrials.gov identifier: NCT02450396
December 2024
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5 Reads
Revue du Rhumatisme
December 2024
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13 Reads
Revue du Rhumatisme
December 2024
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1 Read
Revue du Rhumatisme
December 2024
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2 Reads
Revue du Rhumatisme
December 2024
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6 Reads
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1 Citation
Revue du Rhumatisme
December 2024
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8 Reads
Revue du Rhumatisme
... The initial step in both RMD Open RMD Open RMD Open approaches involves tapering GC doses to physiological replacement levels, following a switch from long-acting GCs (eg, dexamethasone or betamethasone) to shortacting GCs (eg, prednisone or hydrocortisone) when applicable. Interestingly, the recent STAR study demonstrated that tapering prednisone by 1 mg/day each month or replacing prednisone with 20 mg/day of hydrocortisone for 3 months, followed by a reduction to 10 mg/ day for an additional 3 months, resulted in comparable rates of successful GC withdrawal at 1 year in patients with RA. 22 Once tapering of GC doses to physiological levels has been achieved, the ESE/ES experts propose two options: either gradually tapering GCs while monitoring for clinical signs of adrenal insufficiency (option 1), or, more cautiously, assessing morning serum cortisol levels at least 24 hours after the last GC dose (option 2). To date, no studies have shown the superiority of either approach. ...
October 2024
Annals of the Rheumatic Diseases
... In a recent study of the Cruces-Bordeaux inception Lupus cohort, we observed high rates of DORIS remission during 5 consecutive years after the diagnosis [9], thus providing us with an optimal environment to study the effects of GC withdrawal vs. maintenance of low doses on damage accrual in the absence of lupus activity. ...
May 2024
... A PMR-AS between 17 and 7 can be regarded as the range for medium disease activity, 17 for high, and 1.5-7 for low disease activity. A PMR-AS between 1.5 and 0 can be regarded as the remission [10]. Five milliliters of venous blood was collected aseptically from all subjects. ...
March 2024
... Scalp, tongue, or lip necrosis may be seen. In a recent multicenter case control study, scalp tenderness and cognitive disorder were risk factors for the development of this complication [38]. Granulomatous nodules have also been reported in GCA [39]. ...
December 2023
Seminars in Arthritis and Rheumatism
... In a recently published multicentre, retrospective, observational study of 20 cancer patients with ICI-IA [16], 13 were treated with an agent targeting IL-6R (65%), mostly tocilizumab s.c. (n = 12) and 5 (25%) with a TNFi (adalimumab n = 2, etanercept n = 2, and infliximab n = 1), while one patient each was treated with the IL-1R antagonist anakinra, the JAKi baricitinib and the anti-IL-12/23 monoclonal antibody ustekinumab, all for 17 weeks (median). ...
November 2023
... This therapy can be highly effective but exerts broader effects beyond the IFN-I pathway and is associated with treatment-emergent infections in most patients [8]. Anifrolumab (Saphnelo®, Astra Zeneca AB), is a humanized IgG1k monoclonal antibody therapy that binds to a subunit of the IFN-I receptor (IFNAR1) and was recently approved to treat adult patients with Systemic Lupus Erythematosus (SLE) [9,17,18,19,20]. Doroudchi et al., recently described the use of Anifrolumab in a patient with DNASE2 deficiency and elevated IFN-I [10] and an ongoing study (NCT02974595) is assessing this treatment for diverse sets of IFN-I mediated autoinflammatory diseases [11]. ...
October 2023
... The specificity was even higher when the SEMA4A level was combined with DAS 28-CRP > 3.2 or Doppler ultrasound screening (HR 10.42, 95% CI 1.41-76.94) [66]. ...
September 2023
... Several studies have reported clinical data about different frail populations such as hematological malignancies, kidney and liver transplant recipients, patients with end-stage renal disease on chronic hemodialysis, autoimmune diseases, and other important comorbidities. Most of these studies observed that in populations unresponsive to vaccination, tixagevimab/cilgavimab pre-exposure prophylaxis was associated with lower incidence of COVID-19 and severe infection [15][16][17][18][19]. These clinical studies were conducted across various timeframes, resulting in patient exposure to diverse variants of concern (VOCs). ...
August 2023
British Journal of Rheumatology
... This highlights the importance of careful monitoring of health parameters when using such medications in clinical practice. 34 However, only 40% to 60% of patients achieving low disease activity and up to 20% reaching remission after DMARDs administrated, 35 even patients in sustained druginduced remission can experience disease flares, which both risk incremental joint damage and limit physical function and quality of life. 36 Effective biomarkers, especially for the early stage, have not been established due to the significant heterogeneity of RA. ...
July 2023
JAMA Network Open
... In the phase III SELECTION trial of filgotinib for ulcerative colitis, pulmonary embolism was observed in only one patient (1/507, 0.2%) during induction; pulmonary embolism was not observed during maintenance 134 . Fleischmann and colleagues reported pooled safety data from six phase III upadacitinib trials for rheumatoid arthritis and specifically identified a high-risk population (age ≥50 years and with at least one cardiovascular risk factor), and observed no increased risk of MACE, malignancy or VTE compared with TNF antagonists or methotrexate 135 . In this context, and in contrast to the US FDA position, the EMA updated the recommendations for JAK inhibitors, stating that they are to be used with caution in patients aged ≥65 years, those with risk factors for major cardiovascular problems, VTE or cancer, and in those who smoke or have an extensive smoking history 136 . ...
June 2023
Annals of the Rheumatic Diseases