Publications by authors named "Steve Mathieu"

7 Publications

  • Page 1 of 1

Inhibition of IL-13: A New Pathway for Atopic Dermatitis.

J Cutan Med Surg 2020 Dec 22:1203475420982553. Epub 2020 Dec 22.

54473 Division of Dermatology, McGill University Health Centre, Montreal, QC, Canada.

Dupilumab, a monoclonal antibody against the common receptor of interleukin (IL)-4 and IL-13, was the first biologic therapy approved in Canada for treatment of moderate-to-severe atopic dermatitis (AD). While it is considered safe and effective, dupilumab is not universally effective and 8%-38% of patients develop conjunctivitis, while some patients develop head and neck dermatitis. Thus, new therapeutic options are warranted. While both IL-4 and IL-13 play important roles in the pathogenesis of AD, it has been recently demonstrated that IL-13 is the primary upregulated cytokine in AD skin biopsy samples. A placebo-controlled phase 2b clinical trial evaluating the efficacy and safety of lebrikizumab, an IL-13 inhibitor, in AD demonstrated that, at 16 weeks, Eczema Area and Severity Index (EASI) 75 and Investigator's Global Assessment (IGA) 0/1 were achieved by 60.6% and 44.6% of patients taking lebrikizumab at its highest dose (vs 24.3% and 15.3% of patients taking placebo, respectively). Moreover, treatment with lebrikizumab was associated with rapid improvement of pruritus and low rates of conjunctivitis (1.4%-3.8%). Another IL-13 monoclonal antibody, tralokinumab, was evaluated for safety and efficacy in moderate-to-severe AD. By week 12, among adults receiving 300 mg tralokinumab, 42.5% achieved EASI-75 and 26.7% achieved IGA 0/1 score (vs 15.5% and 11.8% in the placebo group, respectively). Both lebrikizumab and tralokinumab demonstrated acceptable safety profiles in AD (and non-AD) trials with adverse events often being comparable between treatment and control groups. Thus, IL-13 inhibitors may provide a safe and effective treatment alternative for patients with moderate-to-severe AD.
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http://dx.doi.org/10.1177/1203475420982553DOI Listing
December 2020

Case of Erdheim-Chester presenting with xanthelasma-like eruption and osteolytic bone lesions: A case report.

SAGE Open Med Case Rep 2019 6;7:2050313X19845217. Epub 2019 May 6.

Department of Anatomic Pathology, Hôpital du Saint-Sacrement, CHU de Québec-Université Laval, Québec, QC, Canada.

Erdheim-Chester disease is a rare multisystemic non-Langerhans cell histiocytosis presenting 95% with skeletal lesions. Erdheim-Chester disease is due to mutations in the RAS-MEK-ERK pathway where 50% are due to BRAF-V600E mutations. Typical histopathological, clinical, and radiologic features are necessary for the diagnosis of Erdheim-Chester disease. Prognosis depends on the extent of the systemic involvement, and central nervous system involvement has a poorer outcome. We present a 30-year-old Moroccan woman with diabetes insipidus, bone marrow, and asymmetrical axial osteolytic bone lesions. Biopsies were consistent with Erdheim-Chester disease. Despite no treatment, the patient has demonstrated clinical improvement.
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http://dx.doi.org/10.1177/2050313X19845217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503601PMC
May 2019

CANDLE: The critical analysis of the nocturnal distribution of light exposure - A prospective pilot study quantifying the nocturnal light intensity on a critical care unit.

J Intensive Care Soc 2018 Aug 15;19(3):196-200. Epub 2017 Dec 15.

Queen Alexandra Hospital, Portsmouth, UK.

Patients with critical illness have disrupted circadian rhythms, which can lead to increased morbidity, mortality and length of intensive care unit stay. Light intensity within the intensive care unit influences the circadian rhythm and may therefore impact on patient outcome. We performed an observational single-centre pilot study monitoring nocturnal light exposure of intensive care unit patients between November and December 2016. As there are currently no medical guidance on recommended light levels, we audited our findings against building regulation standards. The median light intensity was 1.5 lux, which is below the 20 lux standards; however, there were significant outliers. There was positive correlation between patient illness severity based on SOFA score and maximum lux (R = 0.45, P = 0.026); however, there was no relationship between patient illness severity and median lux exposure (R = 0.23, P = 0.28). As illness severity increased so did the time spent greater than 20 lux (R = 0.59, P = 0.0021), and the individual occasions where lux breached the 20 lux limit (R = 0.52, P = 0.009). There was no relationship between illness severity of neighbouring patients and maximum lux (R = -0.11, P = 0.69) or neighbouring illness severity and median lux (R = -0.04, P = 0.87). This preliminary work will form the basis of future projects, including national guidance and evaluating the impact of environmental light on patient-centred outcomes.
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http://dx.doi.org/10.1177/1751143717748095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110023PMC
August 2018

Generalized Recalcitrant Pruritus as the Presenting Manifestation of Hypereosinophilic Syndrome.

J Cutan Med Surg 2016 Jul 29;20(4):346-8. Epub 2016 Jan 29.

Laval University, Hôtel Dieu de Québec, CHU, Québec City, QC, Canada.

Background And Objective: Pruritus is a frequent occurrence in dermatology, and investigation is often unrevealing. The authors report the case of a 65-year-old man presenting with generalized recalcitrant pruritus as the presenting manifestation of hypereosinophilic syndrome.

Methods And Results: A 65-year-old man developed intractable pruritus. Results of polymerase chain reaction clonal rearrangement were positive and led to the diagnosis and treatment. The patient also developed massive pulmonary embolism, which can be caused by chronic eosinophilia.

Conclusions: This case highlights the importance of investigating patients with pruritus and unexplained persistent eosinophilia. Hypereosinophilic syndrome must be included in the differential diagnosis, which in this case presented initially as intractable pruritus. Polymerase chain reaction clonal rearrangement was key in reinforcing the diagnosis.
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http://dx.doi.org/10.1177/1203475416629603DOI Listing
July 2016

Systemic Sarcoidosis Revealed by Axillary Electrolysis.

J Cutan Med Surg 2015 Jul-Aug;19(4):404-6. Epub 2015 Mar 2.

Department of Medicine, Service of Dermatology, Hôpital St-Sacrement, CHU Laval, CHU Québec, Université Laval, Quebec, Canada.

Background: Sarcoidosis is a noncaseating granulomatous disease that affects a large variety of organs and tissues. Skin sarcoidosis is commonly found in scar and tattooed tissues.

Objective: To report this particular case of sarcoidosis following electrolysis hair removal.

Method: We report the case of a woman who developed sarcoidosis years after axillary electrolysis hair removal.

Results: The diagnosis of cutaneous sarcoidosis was suggested by the clinical manifestations and confirmed by histopathologic findings.

Conclusion: Sarcoidosis should be considered during the investigation of skin lesions occurring in scar or traumatized tissue.
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http://dx.doi.org/10.1177/1203475415575016DOI Listing
October 2015

BET 1: levosimendan in septic shock.

Emerg Med J 2014 Jun;31(6):508-10

A shortcut review was carried out to establish whether levosimendan improves outcome in septic shock. Eight studies were directly relevant to the question. The author, date and country of publication, patient groups studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that there is as yet no evidence that levosimendan reduces mortality from septic shock. The LeoPARDS trial may change that.
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http://dx.doi.org/10.1136/emermed-2014-203854.1DOI Listing
June 2014

Is central venous pressure monitoring appropriate for assessment of perioperative fluid balance?

Br J Hosp Med (Lond) 2006 Feb;67(2):108

Royal Bournemouth Hospital.

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http://dx.doi.org/10.12968/hmed.2006.67.2.20476DOI Listing
February 2006