Publications by authors named "Bernard Combe"
Background: Janus kinase inhibitors are an effective option for achieving sustained remission or low disease activity in patients with rheumatoid arthritis (RA) following inadequate response to conventional synthetic disease-modifying anti-rheumatic drugs. Filgotinib is a Janus kinase 1-preferential inhibitor available in two doses for moderate-to-severe RA. We report the long-term efficacy and safety of filgotinib.
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- The study aimed to evaluate how ultrasonography-detected synovitis progresses in rheumatoid arthritis patients in remission over a year and its ability to predict future relapses or radiographic progression.
- An independent investigator conducted ultrasonography every three months, finding that a significant number of patients exhibited persistent synovitis, indicating ongoing inflammation.
- Key predictors of relapse or progression included persistent synovitis observed through ultrasonography and an increase in disease activity scores right before a relapse occurred.
Objective: To evaluate the efficacy and safety of upadacitinib over 5 years among patients with rheumatoid arthritis (RA) in a long-term extension (LTE) of the SELECT-BEYOND phase 3 trial.
Methods: Patients refractory to ≥1 biological disease-modifying antirheumatic drug (DMARD) received upadacitinib 15 mg or 30 mg once daily or placebo, in combination with background conventional synthetic DMARD(s). At week 12, patients randomised to placebo were switched to upadacitinib 15 mg or 30 mg.
Background: Inception cohorts aim to describe chronic diseases from diagnosis and over years of follow-up. Axial spondyloarthritis (axSpA) diagnosis might be challenging during the first years of the disease. Thus, identifying the features that will be associated with a confirmed diagnosis over time is key.
View Article and Find Full Text PDFObjective: To assess whether using ultrasound (US) in addition to clinical information versus only clinical information in a treat-to-target (T2T) strategy leads to more clinical remission and to less radiographic progression in RA.
Methods: Patients with RA from the 2-year prospective BIODAM cohort were included. Clinical and US data (US7-score) were collected every 3 months and hands and feet radiographs every 6 months.
We aimed to evaluate the value of the Fibrosis-4 (FIB-4) score as a prognostic factor in RA in the prospective ESPOIR cohort. We included patients from the ESPOIR cohort with a diagnosis of RA according to ACR/EULAR criteria. The formula for the FIB-4 score is as follows: [age (years) × aspartate transaminase level (U/L)]/[platelet count (10/L) × alanine aminotransferase level (U/L)].
View Article and Find Full Text PDFObjectives: We evaluated the risk of severe infection in patients with immune-mediated inflammatory disease (IMID) treated with RTX and with Ig deficiency.
Methods: This was an observational, retrospective single-centre study of patients undergoing treatment with at least one rituximab (RTX) infusion for an IMID until 31 May 2020. Patients were followed up for at least 12 months after the last infusion or until severe infection or death.
Objectives: This study aimed to evaluate the 10-year clinical outcome of patients with recent-onset axial spondyloarthritis (axSpA).
Methods Study Design: The DESIR cohort is an inception cohort of axSpA patients.
Methods Diagnosis And Management: The diagnosis and management of patients were based on the decision of the treating rheumatologist.
Objectives: The objective of this study is to evaluate whether there are differences in the long-term prognosis across various phenotypes of early arthritis (EA).
Methods: Three EA cohorts (Reade, Etude et Suivi des Polyarthrites Indifférenciées Récentes (ESPOIR) and Early Arthritis Clinic (EAC)) were analysed. Clinical data were collected up to 24 years.
Objectives: This study aimed to estimate the prevalence of ANCA-associated vasculitis (AAV). That is, granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA), in Southern France in 2018, and evaluate differences among Europeans and non-Europeans.
Methods: This population-based, cross-sectional study used four sources (hospitals, community-based physicians, laboratories, National Health Insurance) to identify adults ≥15 years diagnosed with GPA, MPA or EGPA, living in Hérault and Gard in 2018.
Article Synopsis
- Filgotinib is an oral medication that effectively reduces the progression of rheumatoid arthritis (RA) in patients with inadequate response to methotrexate and shows a good safety profile compared to placebo and methotrexate alone.
- This review analyzes data from phase 3 trials focusing on patients with multiple poor prognostic factors (PPFs) and those at risk for rapid radiographic progression, suggesting that these factors could indicate higher disease risk.
- Ultimately, the findings aim to guide treatment decisions for patients with RA who are at an increased risk for joint damage due to radiographic progression.
Objectives: To investigate whether meticulously following a treat-to-target (T2T)-strategy in daily clinical practice will lead to less radiographic progression in patients with active RA who start (new) DMARD-therapy.
Methods: Patients with RA from 10 countries starting/changing conventional synthetic or biologic DMARDs because of active RA, and in whom treatment intensification according to the T2T principle was pursued, were assessed for disease activity every 3 months for 2 years (RA-BIODAM cohort). The primary outcome was the change in Sharp-van der Heijde (SvdH) score, assessed every 6 months.
Article Synopsis
- The study aimed to explore how social support, financial status, and lifestyle choices affect the level of disability in individuals with rheumatoid arthritis (RA).
- Data were collected from the ESPOIR cohort, analyzing various factors like exercise, education, and financial situation to identify those with "excess disability."
- Results showed that lower social support, worse financial conditions, less exercise, and lower education levels significantly correlated with higher disability, emphasizing the need for better economic and social support for RA patients.
Objective: We aimed to delineate phenotypes in hand osteoarthritis (HOA) based on cardinal symptoms (pain, functional limitation, stiffness, and aesthetic discomfort).
Methods: With data from the Digital Cohort Design (DIGICOD), we performed a hierarchical agglomerative clustering analysis based on Australian/Canadian Osteoarthritis Hand Index (AUSCAN) subscores for pain, physical function, stiffness, and visual analog scale for aesthetic discomfort. Kruskal-Wallis and post hoc analyses were used to assess differences between clusters.
Article Synopsis
- - This study investigated the effectiveness and safety of filgotinib (FIL) in rheumatoid arthritis patients who did not respond well to methotrexate and had four specific poor prognostic factors.
- - Patients were treated with either a placebo, FIL (200 mg or 100 mg), or adalimumab, and the analysis found that those on FIL showed significantly better responses in terms of disease activity at 12 weeks compared to placebo.
- - By 52 weeks, FIL200 not only maintained a greater response compared to adalimumab but also showed less progression in joint damage, with similar tolerability across all treatment groups.
Introduction: Global clinical trials in rheumatoid arthritis (RA) often do not recruit enough patients from diverse racial and ethnic backgrounds to identify any potential differences in treatment outcome across such groups. To overcome this limitation, using data from five previous clinical trials and two ongoing trial extensions, this study aimed to assess the efficacy and safety of filgotinib in patients with RA across geographic regions.
Methods: This was a post hoc, exploratory analysis of data from male and female patients with RA meeting the 2010 RA criteria as defined by the American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology.
Background: Targeting interleukin (IL)-6 has become a major therapeutic strategy in the treatment of immune-mediated inflammatory disease. Interference with the IL-6 pathway can be directed at the specific receptor using anti-IL-6Rα antibodies or by directly inhibiting the IL-6 cytokine. This paper is an update of a previous consensus document, based on most recent evidence and expert opinion, that aims to inform on the medical use of interfering with the IL-6 pathway.
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- The study aimed to evaluate the safety and efficacy of filgotinib, a JAK1 preferential inhibitor, in Japanese patients who had an inadequate response to methotrexate (MTX) over 52 weeks.
- Patients were randomly assigned to receive either filgotinib or adalimumab while continuing stable doses of MTX, with efficacy assessed at various intervals and safety monitored through adverse event reporting.
- Results showed that filgotinib maintained efficacy and safety over the one-year period, with adverse events remaining consistent when compared to the overall population, indicating its potential as a viable treatment option.
Introduction: Long-term safety and efficacy of upadacitinib in patients with active ankylosing spondylitis (AS) has not been previously reported.
Methods: In SELECT-AXIS 1, patients receiving placebo were switched to upadacitinib 15 mg once daily at week 14 while patients initially randomised to upadacitinib continued their regimen through week 104. Efficacy was assessed using as-observed (AO) and non-responder imputation (NRI).
Objectives: To assess, in patients with recent-onset arthritis, whether a self-reported familial occurrence of rheumatoid arthritis (RA) is associated with a clinical presentation of the disease, final diagnosis, long-term outcome and treatment decisions.
Methods: The study was conducted from data of patients included between 2002 and 2005 in the early arthritis ESPOIR cohort. Patients were recruited on the basis of having at least two swollen joints for >6 weeks and <6 months, no other diagnosis than RA and no previous exposure to glucocorticoids or disease-modifying antirheumatic drugs (DMARDs).
Introduction/objectives: To evaluate the three-year efficacy and safety of ixekizumab with and without concomitant conventional synthetic disease-modifying antirheumatic drug (csDMARD) use in patients with active psoriatic arthritis (PsA).
Method: Patients with PsA who were biologic-naïve (SPIRIT-P1, NCT01695239) or had prior inadequate response to tumor necrosis factor inhibitors (SPIRIT-P2, NCT02349295) were randomized to receive 80-mg ixekizumab every four weeks after receiving 160-mg ixekizumab at baseline. Efficacy, safety, and immunogenicity were evaluated in this post-hoc analysis in three subgroups: (1) ixekizumab monotherapy, (2) ixekizumab and methotrexate (MTX), (3) ixekizumab and any csDMARD (including MTX).