Publications by authors named "Daniel Wendling"

377 Publications

Dual Energy CT scan of erosive disk disease: the calcium resorption hypothesis.

Joint Bone Spine 2021 Apr 7:105182. Epub 2021 Apr 7.

Department of Rheumatology, CHRU Besançon, FRANCE; EA 4267: "PEPITE", FHU increase, Université Bourgogne - Franche Comte, UFR SMP, Besançon, France; Department of musculoskeletal imaging, CHRU Besançon, FRANCE; EA 4664 Nanomedicine Imagery and Therapeutics Laboratory, Université Bourgogne - Franche Comté, UFR SMP, Besançon, FRANCE. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2021.105182DOI Listing
April 2021

Le SARS-CoV-2 peut-il induire une arthrite réactionnelle?

Rev Rhum Ed Fr 2021 Apr 2. Epub 2021 Apr 2.

Service de Rhumatologie, CHRU de Besançon, Boulevard Fleming, 25030 Besançon, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rhum.2021.03.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8017909PMC
April 2021

A pragmatic non-invasive assessment of liver fibrosis in patients with psoriasis, rheumatoid arthritis or Crohn's disease receiving methotrexate therapy.

Clin Res Hepatol Gastroenterol 2020 Jan-Jun;44S:100003. Epub 2020 Feb 8.

Service d'hépatologie et de soins intensifs digestifs, CHRU Jean-Minjoz, 25030 Besançon cedex, France.

Background And Aims: The reported hepatotoxicity of methotrexate underlines the need for a repeated non-invasive and reliable evaluation of liver fibrosis. We estimated, using a non-invasive strategy, the prevalence of significant liver fibrosis in patients treated by methotrexate and the predictors of significant fibrosis (fibrosis≥F2).

Methods: Fibrosis was prospectively evaluated using 9 non-invasive tests in consecutive patients with psoriasis, rheumatoid arthritis, or Crohn's disease. Significant fibrosis was assessed without liver biopsy by defining a "specific method" (result given by the majority of the tests) and a "sensitive method" (at least one test indicating a stage≥F2).

Results: One hundred and thirty-one patients (66 Psoriasis, 40 rheumatoid arthritis, and 25 Crohn's disease) were enrolled, including 83 receiving methotrexate. Seven tests were performed on average per patient, with a complete concordance in 75% of cases. Fibroscan® was interpretable in only 61% of patients. The best performances (AUROC>0.9) for predicting significant fibrosis were obtained by tests dedicated to steatohepatitis (FibroMeter NAFLD, NFS and FPI). The prevalence of fibrosis≥F2 according to the "specific" or the "sensitive" assessment of fibrosis was 10% and 28%, respectively. Methotrexate exposure did not influence the fibrosis stage. Factors independently associated with significant fibrosis according our "sensitive method" were age, male gender, and metabolic syndrome.

Conclusion: We provided a non-invasive approach for identifying liver fibrosis≥F2 by using 8 biochemical tests and Fibroscan®. In this population, the risk of significant fibrosis was related to age, male gender, and presence of metabolic syndrome, but was not influenced by methotrexate.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clirex.2020.100003DOI Listing
February 2020

Spinal calcium resorption, a cause of inflammatory back pain.

Joint Bone Spine 2021 Feb 6;88(3):105154. Epub 2021 Feb 6.

Department of rheumatology, CHRU Besançon, Besançon, France; EA 4267: "PEPITE", FHU increase, université Bourgogne - Franche Comte, UFR SMP, Besançon, France. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2021.105154DOI Listing
February 2021

Nail patella syndrome.

Joint Bone Spine 2021 Jan 21;88(3):105139. Epub 2021 Jan 21.

Department of Ophthalmology, CHRU de Besançon, Besançon, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2021.105139DOI Listing
January 2021

Destructive arthropathy of the spine: Consider gout.

Joint Bone Spine 2021 Jan 20;88(3):105134. Epub 2021 Jan 20.

Rheumatology Department, CHRU de Besançon, boulevard Fleming, 25030 Besançon, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2021.105134DOI Listing
January 2021

Dr. Kiltz, reply.

J Rheumatol 2021 Jan 15. Epub 2021 Jan 15.

Rheumazentrum Ruhrgebiet, Herne, and Ruhr-Universität Bochum, Bochum, Germany; Centre Hospitalier Régional Universitaire de Besançon, and EA 4266, EPILAB, Université de Franche-Comté, Besançon, France. The authors declare no conflicts of interest. Address correspondence to Dr. U. Kiltz, Rheumazentrum Ruhrgebiet, Claudiusstr. 45, Herne, NRW 44649, Germany. Email:

We thank Dr. Queiro and colleagues for their interest in our editorial review and the fascinating field of axial spondyloarthritis (axSpA) Queiro and colleagues point out that disease-specific assessments used in routine care for patients with axSpA focus on assessment of disease activity and physical function but do not look much at the considerable variety of symptoms related to axSpA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3899/jrheum.201503DOI Listing
January 2021

Circumscribed myositis ossificans.

Joint Bone Spine 2021 Mar 17;88(2):105119. Epub 2020 Dec 17.

Rheumatology department, CHRU, Besançon, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2020.105119DOI Listing
March 2021

Visceral adiposity in patients with psoriatic arthritis and psoriasis alone and its relationship with metabolic and cardiovascular risk.

Rheumatology (Oxford) 2020 Nov 24. Epub 2020 Nov 24.

Laboratoire de Biochimie Médicale, UF de Biochimie Endocrinienne et Métabolique, CHU de Besançon et EA 3920 Marqueurs pronostiques et facteurs de régulation des pathologies cardiaques et vasculaires, Université de Bourgogne Franche Comté, Besançon, France.

Background: Fat mass distribution, especially in the abdominal visceral region, has been rarely evaluated in patients with PsA or psoriasis (PsO).

Methods: Patients with PsA and patients with PsO alone were evaluated and compared with control subjects (1:1 ratio in each patient group) matched for age, sex and BMI category. Body composition and fat distribution (android and visceral fat) were evaluated by DXA. Anthropometric measurements, disease activity and the systematic coronary risk evaluation (SCORE) cardiovascular risk were assessed. Metabolic parameters (insulin, homeostasis model assessment for insulin resistance), serum adipokines [total and high-molecular-weight adiponectin, leptin, resistin and retinol-binding protein-4 (RBP4)] were measured.

Results: Data for 52 patients with PsA and 52 patients with PsO and their respective paired controls were analysed. Android fat and visceral fat were found to be significantly higher in patients with PsO compared with their controls, while these measurements did not differ between patients with PsA and their controls. By multivariate analysis, after adjusting for age, sex and BMI, visceral fat was higher in PsO patients compared with PsA patients (P = 0.0004) and the whole group of controls (P = 0.0013). Insulin levels and HOMA-IR were increased in both PsA and PsO groups. High-molecular-weight/total adiponectin ratio was decreased in patients with PsO. RBP4 was significantly higher in both PsA and PsO patients. In patients with PsO, visceral fat strongly correlated with SCORE (r = 0.61).

Conclusion: Visceral fat accumulates more in PsO alone than in PsA. Visceral adiposity may be a more pressing concern in PsO relative to PsA.

Trial Registration: The ADIPSO study (Évaluation du tissu ADIpeux et des adipokines dans le PSOriasis et le rhumatisme psoriasique et analyse de ses relations avec le risque cardiovasculaire) is a case-control study conducted in Besançon, France, and is registered on ClinicalTrials.gov under the number NCT02849795.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/rheumatology/keaa720DOI Listing
November 2020

H-NMR-Based Analysis for Exploring Knee Synovial Fluid Metabolite Changes after Local Cryotherapy in Knee Arthritis Patients.

Metabolites 2020 Nov 13;10(11). Epub 2020 Nov 13.

Laboratoire «Mobilité, Vieillissement, Exercice (MOVE)-EA6314», Faculté des Sciences du Sport, Université de Poitiers, 8 Allée Jean Monnet, 86000 Poitiers, France.

Rehabilitation using cryotherapy has widely been used in inflammatory diseases to relieve pain and decrease the disease activity. The aim of this study was to explore the metabolite changes in inflammatory knee-joint synovial fluids following local cryotherapy treatment (ice or cold CO). We used proton nuclear magnetic resonance (H NMR) spectroscopy to assess the metabolite patterns in synovial fluid (SF) in patients with knee arthritis ( = 46) before (D0) and after (D1, 24 h later) two applications of local cryotherapy. Spectra from aqueous samples and organic extracts were obtained with an 11.75 Tesla spectrometer. The metabolite concentrations within the SF were compared between D1 and D0 using multiple comparisons with the application of a false discovery rate (FDR) adjusted at 10% for each metabolite. A total of 32 metabolites/chemical structures were identified including amino acids, organic acids, fatty acids or sugars. Pyruvate, alanine, citrate, threonine was significantly higher at D1 vs D0 ( < 0.05). Tyrosine concentration significantly decreases after cryotherapy application ( < 0.001). We did not observe any effect of gender and cooling technique on metabolite concentrations between D0 and D1 ( > 0.05). The present study provides new insight into a short-term effect of cold stimulus in synovial fluid from patients with knee arthritis. Our observations suggest that the increased level of metabolites involved in energy metabolism may explain the underlying molecular pathways that mediate the antioxidant and anti-inflammatory capacities of cryotherapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/metabo10110460DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696760PMC
November 2020

Uveitis occurrence in early inflammatory back pain. Five years data from the prospective French nationwide DESIR cohort.

Joint Bone Spine 2021 Mar 6;88(2):105100. Epub 2020 Nov 6.

Rhumatologie, CHU Felix Guyon, Saint-Denis, Reunion.

Objective: Uveitis is a frequent extra rheumatological manifestation in axial Spondyloarthritis (SpA). The aim of study was to evaluate the prevalence and incidence of uveitis over the first five years of a prospective nationwide cohort of patients with high suspicion of early axial SpA, and to evaluate its associated factors.

Methods: DESIR is a prospective observational cohort of patients with recent onset inflammatory back pain (more than 3 months, less than 3 years), suggestive of axial SpA, All available factors in the database were compared between patients with and without uveitis at 5 years, by uni and then multivariate analysis. Baseline factors associated with new cases of uveitis occurrence over the 5 years were also analyzed.

Significance: P less than 0.05.

Results: After 5 years, 91 patients (out of 480 with complete follow-up) had at least one uveitis episode, giving an estimated prevalence of 18.9% [95% CI: 15.4-22.4]. In multivariate analysis, uveitis was significantly associated with dactylitis, and elevated ESR. New incident uveitis occurred in 31 cases over 5 years, giving an estimated incidence rate of 1.29 [0.84-1.74]/100 patient-years. Incidence of new uveitis was associated in multivariate analysis with baseline factors: diagnosis of SpA, sacro iliac MRI inflammatory SPARCC score, dactylitis, syndesmophyte score. No significant association was found with HLA-B27, DMARDs, BASDAI, ASDAS, BASFI.

Conclusion: Five-years data of the DESIR cohort allowed an estimation of incidence rate of uveitis of 1.3/100p-y; over five years, uveitis was associated with dactylitis, biologic and sacro iliac MRI inflammation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2020.105100DOI Listing
March 2021

Reply to Aktaş et al. "Local sacroiliac injections in the treatment of spondyloarthritis. What is the evidence?" Joint Bone Spine 2020. DOI:10.1016/j.jbspin.2020.105083.

Authors:
Daniel Wendling

Joint Bone Spine 2021 03 3;88(2):105094. Epub 2020 Nov 3.

Department of Rheumatology, University Teaching Hospital, CHRU de Besançon, boulevard Fleming, 25030 Besançon, France; EA4266, EPILAB, université Bourgogne-Franche-Comté, 25030 Besançon, France. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2020.105094DOI Listing
March 2021

Prognostic value of 18F-fluorodeoxyglucose PET-CT score at baseline on the therapeutic response to prednisone in patients with polymyalgia rheumatica.

Joint Bone Spine 2021 01 29;88(1):105093. Epub 2020 Oct 29.

Department of rheumatology, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France; EA 4267 « PEPITE », UFR santé, Franche-Comté university, 19, rue Ambroise Paré, bâtiment S, 25030 Besançon cedex, France. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2020.105093DOI Listing
January 2021

Can SARS-CoV-2 trigger reactive arthritis?

Joint Bone Spine 2021 01 27;88(1):105086. Epub 2020 Oct 27.

Service de rhumatologie, CHRU de Besançon, boulevard Fleming, 25030 Besançon, France; EA 4267, PEPITE, université Bourgogne Franche-Comté, Besançon, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2020.105086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590820PMC
January 2021

Evaluation of the impact of a nurse-led program of patient self-assessment and self-management in axial spondyloarthritis: results of a prospective, multicentre, randomized, controlled trial (COMEDSPA).

Rheumatology (Oxford) 2021 02;60(2):888-895

Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, France.

Objective: To evaluate the impact of a nurse-led program of self-management and self-assessment of disease activity in axial spondyloarthritis.

Methods: Prospective, randomized, controlled, open, 12-month trial (NCT02374749). Participants were consecutive axial spondyloarthritis patients (according to the rheumatologist) and nurses having participated in a 1-day training meeting. The program included self-management: educational video and specific video of graduated, home-based exercises for patients; and self-assessment: video presenting the rationale of tight monitoring of disease activity with composite scores (Ankylosing Spondylitis Disease activity Score, ASDAS/Bath Ankyslosing Spondylitis Disease Activity Index, BASDAI). The nurse trained patients to collect, calculate and report (monthly) ASDAS/BASDAI. Treatment allocation was by random allocation to this program or a comorbidities assessment (not presented here and considered here as the control group).

Results: A total of 502 patients (250 and 252 in the active and control groups, respectively) were enrolled (age: 46.7 (12.2) years, male gender: 62.7%, disease duration: 13.7 (11.0) years). After the one-year follow-up period, the adherence to the self-assessment program was considered good (i.e. 79% reported scores >6 times). Despite a lack of statistical significance in the primary outcome (e.g. coping) there was a statistically significant difference in favor of this program for the following variables: change in BASDAI, number and duration of the home exercises in the active group, and physical activity (international physical activity score, IPAQ).

Conclusion: This study suggests a short-term benefit of a nurse-led program on self-management and self-assessment for disease activity in a young axial spondyloarthritis population in terms of disease activity, exercises and physical activity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/rheumatology/keaa480DOI Listing
February 2021

Efficacy of tocilizumab in patients with hand osteoarthritis: double blind, randomised, placebo-controlled, multicentre trial.

Ann Rheum Dis 2020 Oct 14. Epub 2020 Oct 14.

Department of Rheumatology, APHP Henri Mondor Hospital, Créteil, France.

Objective: To evaluate the efficacy of tocilizumab, an antibody against IL-6 receptor, in patients with hand osteoarthritis.

Methods: This was a multicentre, 12-week, randomised, double-blind, placebo-controlled study from November 2015 to October 2018. Patients with symptomatic hand osteoarthritis (pain ≥40 on a 0-100 mm visual analogue scale (VAS) despite analgesics and non-steroidal anti-inflammatory drugs; at least three painful joints, Kellgren-Lawrence grade ≥2) were randomised to receive two infusions 4 weeks apart (weeks 0 and 4) of tocilizumab (8 mg/kg intravenous) or placebo. The primary endpoint was changed in VAS pain at week 6. Secondary outcomes included the number of painful and swollen joints, duration of morning stiffness, patients' and physicians' global assessment and function scores.

Results: Of 104 patients screened, 91 (45 to tocilizumab and 46 to placebo; 82% women; mean age 64.4 (SD 8.7) years) were randomly assigned and 79 completed the 12-week study visit. The mean change between baseline and week 6 on the VAS for pain (primary outcome) was -7.9 (SD 19.4) and -9.9 (SD 20.1) in the tocilizumab and placebo groups (p=0.7). The groups did not differ for any secondary outcomes at weeks 4, 6, 8 or 12. Overall, adverse events were slightly more frequent in the tocilizumab than placebo group.

Conclusion: Tocilizumab was no more effective than placebo for pain relief in patients with hand osteoarthritis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/annrheumdis-2020-218547DOI Listing
October 2020

ASAS Health Index: The "All in One" for Spondyloarthritis Evaluation?

J Rheumatol 2020 10;47(10):1457-1460

U. Kiltz, MD, PhD, Rheumatologist, J. Braun, MD, Professor of Rheumatology, Head of Department, Rheumazentrum Ruhrgebiet, Herne, and Ruhr-University Bochum, Bochum, Germany.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3899/jrheum.200708DOI Listing
October 2020

Low Back Pain and Sacroiliitis on Cross-Sectional Abdominal Imaging for Axial Spondyloarthritis Diagnosis in Inflammatory Bowel Diseases.

Inflamm Intest Dis 2020 Aug 3;5(3):124-131. Epub 2020 Jun 3.

Department of Rheumatology, IMoPA, University Hospital of Nancy, Lorraine University, Nancy, France.

Background: Joint damage is the most frequent extraintestinal manifestation in inflammatory bowel disease (IBD).

Aims: The aim of the study was to assess the value of low back pain (LBP) associated with sacroiliitis on abdominal imaging for the diagnosis of spondyloarthritis (SpA) in IBD.

Methods: We used a questionnaire assessing rheumatological symptoms for all patients with abdominal computed tomography (CT) and magnetic resonance enterography (MRE). Sacroiliitis was assessed on available CT and MRE. Patients were classified as axial SpA according to the Assessment of SpondyloArthritis International Society criteria.

Results: Fifty-one patients completed the questionnaire and performed both exams. LBP was present in 27 patients (52.9%), and 10 (19.6%) had an inflammatory component. Sacroiliitis was reported in 12 patients (23.5%), and 6 of them suffered from LBP. Among the 20 patients referred to the rheumatologist, 11 patients suffered from LBP. One patient was HLA-B27 positive and presented sacroiliitis. For the last 10 patients, none of them had a sacroiliitis, and 2 patients were negative for HLA-B27.

Conclusion: An axial SpA has been diagnosed in 11.8% of IBD patients undergoing cross-sectional imaging, whereas one-fifth had inflammatory LBP, and sacroiliitis was observed in one-quarter of them. To optimize the diagnosis of axial SpA, HLA-B27 testing might be required for patients with both IBD and LBP, but this will require further investigation before its implementation in routine practice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000507930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506218PMC
August 2020

Increased high molecular weight adiponectin and lean mass during tocilizumab treatment in patients with rheumatoid arthritis: a 12-month multicentre study.

Arthritis Res Ther 2020 09 29;22(1):224. Epub 2020 Sep 29.

Laboratoire de Biochimie Médicale, UF de Biochimie Endocrinienne et Métabolique, CHU de Besançon; EA 3920 Marqueurs pronostiques et facteurs de régulation des pathologies cardiaques et vasculaires, Université de Bourgogne Franche Comté, Besançon, France.

Background: Patients with rheumatoid arthritis (RA) have an increased risk of cardiovascular (CV) disease. Adiponectin is involved in the metabolism of glucose and lipids with favourable effects on CV disease, especially its high molecular weight (HMW) isoform. Body composition changes are described in RA with various phenotypes including obesity. The effects of tocilizumab on serum adiponectin and body composition, especially fat mass, in patients with RA are not well determined.

Methods: Patients with active RA despite previous csDMARDs and/or bDMARDs and who were tocilizumab naïve were enrolled in a multicentre open-label study. They were evaluated at baseline, 1, 3, 6 and 12 months. Clinical assessment included body mass index (BMI) and anthropometric measurements. Lipid and metabolic parameters, serum adiponectin (total and HMW), leptin, resistin and ghrelin were measured at each time point. Body composition (lean mass, fat mass, % fat, fat in the android and gynoid regions) was evaluated at baseline, 6 and 12 months.

Results: One hundred seven patients were included. Both total and HMW adiponectin significantly increased from baseline to month 3, peaking respectively at month 3 (p = 0.0105) and month 1 (p < 0.0001), then declining progressively until month 6 to 12 and returning to baseline values. Significant elevation in HMW adiponectin persisted at month 6 (p = 0.001). BMI and waist circumference significantly increased at month 6 and 12, as well as lean mass at month 6 (p = 0.0097). Fat mass, percentage fat and android fat did not change over the study period. Lipid parameters (total cholesterol and LDL cholesterol) increased while glycaemia, insulin and HOMA-IR remained stable. Serum leptin, resistin and ghrelin did not change during follow-up.

Conclusions: Tocilizumab treatment in RA patients was associated with a significant increase in total and HMW adiponectin, especially at the onset of the treatment. Tocilizumab also induced a significant gain in lean mass, while fat mass did not change. These variations in adiponectin levels during tocilizumab treatment could have positive effects on the CV risk of RA patients. In addition, tocilizumab may have an anabolic impact on lean mass/skeletal muscle.

Trial Registration: The ADIPRAT study was a phase IV open-label multicentre study retrospectively registered on ClinicalTrials.gov under the number NCT02843789 (date of registration: July 26, 2016).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13075-020-02297-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523335PMC
September 2020

Inflammation of the sacroiliac joints and spine on MRI predicts structural changes on MRI in axial spondyloarthritis: 5-year data from DESIR.

Arthritis Care Res (Hoboken) 2020 Sep 16. Epub 2020 Sep 16.

Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/acr.24449DOI Listing
September 2020

Rituximab for rheumatoid arthritis-associated large granular lymphocytic leukemia, a retrospective case series.

Semin Arthritis Rheum 2020 10 16;50(5):1109-1113. Epub 2020 Jun 16.

Rheumatology Department, University Hospital, 58 Rue Montalembert, Clermont-Ferrand, France.

Objectives: To assess the efficacy and tolerance profile of rituximab in rheumatoid arthritis (RA)-associated large granular lymphocyte leukemia (LGLL).

Methods: Multicenter retrospective case series. Inclusion criteria were RA defined by the ACR/EULAR 2010 criteria and LGLL defined by absolute LGL count ≥ 0.3 × 10/L with evidence of an expanded clonal LGL population (flow cytometry, TCR-γ polymerase chain reaction, or Stat3 mutation).

Results: Fourteen patients (10 women, mean age 55.2 ± 14.2 years) included; 13 were seropositive for anti-cyclic citrullinated peptides (n = 11) or rheumatoid factor (n = 10). LGLL diagnosis was made 9.5 [IQR: 3.25;15.5] years after RA diagnosis. Thirteen patients had T-LGLL. Rituximab was the first-line therapy for LGLL for 4 patients. Previous treatment lines included methotrexate (n = 7), cyclophosphamide (n = 2), cyclosporin A (n = 1), or granulocyte colony-stimulating factor (n = 4). Rituximab was used in monotherapy (n = 8) or associated to methotrexate (n = 3), granulocyte colony-stimulating factor (n = 2), or alkylating agents (n = 1). The number of rituximab cycles ranged from 1 to 11 (median 6), with high heterogeneity in dosing regimens. Median duration response after rituximab initiation was 35 [IQR: 23.5;41] months. The overall response rate was 100%: 8 patients experienced complete response (normalization of blood count and LGL ≤ 0.3 × 10/L) and 6 experienced partial responses (improvement in blood counts without complete normalization). The tolerance profile was good, with no infectious complications.

Conclusion: rituximab appears as a valuable therapeutic option for RA-associated LGLL.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.semarthrit.2020.05.020DOI Listing
October 2020

Adjuvant-induced arthritis is a relevant model to mimic coronary and myocardial impairments in rheumatoid arthritis.

Joint Bone Spine 2021 01 10;88(1):105069. Epub 2020 Sep 10.

PEPITE EA 4267, FHU INCREASE, University Bourgogne Franche-Comté, 25000 Besançon, France. Electronic address:

Objectives: To determine if the adjuvant-induced arthritis model reproduced coronary and cardiac impairments observed in rheumatoid arthritis patients. The link between disease activity and circulating levels of angiotensin II and endothelin-1 have been studied, as well as the myocardial susceptibility to ischemia.

Methods: At the acute inflammatory phase, coronary reactivity was assessed in isolated arteries, and cardiac function was studied in isolated perfused hearts, before and after global ischemia/reperfusion. Ischemic insult was evaluated by the infarct size, lactate dehydrogenase and creatine phosphokinase levels in coronary effluents. Cardiac myeloperoxidase activity was measured, as well as angiotensin II and endothelin-1 levels.

Results: Compared to controls, adjuvant-induced arthritis had reduced coronary Acetylcholine-induced relaxation associated with cardiac hypertrophy, both being correlated with plasma levels of endothelin-1 and angiotensin II, and arthritis score. Although cardiac function at baseline was similar from controls, adjuvant-induced arthritis rats exhibited lower cardiac functional recovery, increased myeloperoxidase activity, higher infarct size and creatine phosphokinase levels after ischemia/reperfusion.

Conclusions: The adjuvant-induced arthritis model displays coronary endothelial dysfunction associated with myocardial hypertrophy and a reduced tolerance to ischemia. This model might be useful for deciphering the pathophysiology of cardiac dysfunction in rheumatoid arthritis and paves the way for studying the role of endothelin-1 and angiotensin II.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2020.09.001DOI Listing
January 2021

Serum calprotectin is increased in early axial spondyloarthritis with sacroiliitis and objective signs of inflammation: Results from the DESIR cohort.

Joint Bone Spine 2021 01 5;88(1):105068. Epub 2020 Sep 5.

Department of Rheumatology, CHU Grenoble Alpes, Echirolles, France; University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2020.08.003DOI Listing
January 2021

Part of pain labelled neuropathic in rheumatic disease might be rather nociplastic.

RMD Open 2020 09;6(2)

U987, INSERM, Boulogne Billancourt, France.

Pain in rheumatic diseases is primarily due to mechanical or inflammatory mechanism, but neuropathic pain (NP) component is also occurring in many conditions and is probably underdiagnosed. The purpose of this article is to provide an overview of prevalence, pathophysiological and currently available treatment of NP in rheumatic diseases. When associated with clinical evaluation assessing neurological clinical signs and neuroanatomical distribution, Douleur Neuropathique 4 Questions, painDETECT, Leeds assessment of neuropathic symptoms and signs and Neuropathic Pain Questionnaire can detect NP component. Inflammatory or connective diseases, osteoarthritis, back pain or persistent pain after surgery are aetiologies that all may have a neuropathic component. Unlike nociceptive pain, NP does not respond to usual analgesics such as paracetamol and non-steroidal anti-inflammatory drugs. Entrapment neuropathy, peripheral neuropathy or small-fibre neuropathy are different aetiologies that can lead to NP. A part of the pain labelled neuropathic is rather nociplastic, secondary to a central sensitisation mechanism. Identifying the right component of pain (nociceptive vs neuropathic or nociplastic) could help to better manage pain in rheumatic diseases with pharmacological and non-pharmacological treatments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/rmdopen-2020-001326DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508212PMC
September 2020

Deciding who to treat with biologic disease-modifying antirheumatic drugs in axial spondyloarthritis.

Immunotherapy 2020 08 7;12(12):857-860. Epub 2020 Jul 7.

Service de Rhumatologie, CHRU de Tours EA 7501, GICC, Université de Tours, Tours, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/imt-2020-0094DOI Listing
August 2020

Impact of glucocorticoids on systemic sirtuin 1 expression and activity in rats with adjuvant-induced arthritis.

Epigenetics 2021 Jan-Feb;16(2):132-143. Epub 2020 Jul 13.

Pathogens & Inflammation/EPILAB Laboratory, UPRES EA 4266, SFR FED 4234, University of Franche-Comté, Université Bourgogne Franche-Comté (UBFC) , Besançon, France.

The class III histone deacetylase sirtuin 1 (SIRT1) plays a pivotal role in numerous biological and physiological functions, including inflammation. An association between SIRT1 and proinflammatory cytokines might exist. In addition to their important role in inflammation associated with rheumatoid arthritis (RA), proinflammatory cytokines mediate the development of systemic effects. Here, we evaluated systemic SIRT1 expression and enzymatic activity, in peripheral blood mononuclear cells (PBMCs) and in liver isolated from rats with adjuvant-induced arthritis (AIA), treated or not with low or high doses of glucocorticoids (GCs). We also measured the production of tumour necrosis factor alpha (TNF) and interleukin-1 beta (IL-1 beta) in PBMCs and liver. We found that SIRT1 expression and activity increased in PBMCs of AIA rats compared to healthy controls and decreased under GC treatment. Similarly, we observed an increased SIRT1 activity in the liver of AIA rats compared to healthy controls which decreased under high doses of GCs. We also found an increase in IL-1 beta and TNF levels in the liver of AIA rats compared to healthy controls, which decreased under high doses of GC. We did not observe a significant correlation between SIRT1 activity and proinflammatory cytokine production in PBMC or liver. In contrast, a strong positive correlation was found between the liver levels of TNF and IL-1 beta (rho=0.9503, p=7.5x10). Our results indicate that increased inflammation in AIA rats compared to healthy control is accompanied by an increased SIRT1 activity in both PBMCs and liver, which could be decreased under GC treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/15592294.2020.1790789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889198PMC
July 2020

Toward a tailored therapeutic prescription for patients with axial spondyloarthritis.

Joint Bone Spine 2021 03 10;88(2):105019. Epub 2020 Jun 10.

Service de Rhumatologie, CHRU de Besançon; EA 4266, Université de Franche-Comté, Besançon, France. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbspin.2020.05.008DOI Listing
March 2021

From observational studies to personalized treatment in spondylarthritis: focus on IL-17 inhibition.

Expert Opin Biol Ther 2020 08 17;20(8):837-840. Epub 2020 Jun 17.

Service de Rhumatologie, CHRU de Tours; EA 7501, GICC, Université de Tours , Tours, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14712598.2020.1782382DOI Listing
August 2020

Evaluation of the impact of a nurse-led program of systematic screening of comorbidities in patients with axial spondyloarthritis: The results of the COMEDSPA prospective, controlled, one year randomized trial.

Semin Arthritis Rheum 2020 08 27;50(4):701-708. Epub 2020 May 27.

Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Université de Paris, INSERM U-1153, CRESS, Paris, France.

Objective: To evaluate the impact of a nurse-led program of systematic screening for the management (detection/prevention) of comorbidities.

Methods: Prospective, randomized, controlled, open, 12-month trial (NCT02374749).

Participants: consecutive patients with axial Spondyloarthritis (axSpA) (according to the rheumatologist) THE PROGRAM: A nurse collected data on comorbidities during a specific outpatient visit. In the event of non-agreement with recommendations, the patient was informed and a specific recommendation was given to the patient (orally and in a with a detailed written report). Patients were seen after one year in a nurse-led visit. TREATMENT ALLOCATION: random allocation (i.e. either this program or an educational program not presented here and considered here as the control group).

Main Outcome: change after one year of a weighted comorbidity management score (0 to 100 where 0= optimal management).

Results: 502 patients were included (252 and 250 in the active and control groups, respectively): age: 47±12 years, male gender: 63%, disease duration: 14±11y. After one year, no differences were observed in a weighted comorbidity management score. However, the number of patients in agreement with recommendations was significantly higher in the active group for vaccinations (flu vaccination: 28.6% vs. 9.9%, p<0.01; pneumococcal vaccination:40.0% vs. 21.1%,p=0.04), for cancer screening (skin cancer screening: 36.3% vs. 17.2%, p=0.04) and for osteoporosis (bone densitometry performed: 22.6% vs. 8.7%, p<0.01; Vitamin D supplementation initiation: 51.9% vs. 9.4%, p<0.01).

Conclusions And Relevance: This study suggests the short-term benefit of a single-visit nurse-led program for systematic screening of comorbidities for its management in agreement with recommendations, even in this young population of patients with axSpA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.semarthrit.2020.05.012DOI Listing
August 2020