Publications by authors named "Combe B"
Objectives: To describe safety and efficacy of filgotinib 200 or 100 mg (FIL200/FIL100) in Japanese patients with rheumatoid arthritis in a long-term extension (LTE; NCT03025308).
Methods: Patients who completed any of three parent studies (NCT02889796: inadequate response [IR] to methotrexate [MTX]; NCT02873936: IR to biologic disease-modifying antirheumatic drugs; NCT02886728: MTX-naïve) without rescue therapy could enter the LTE; patients taking FIL continued their dosage, and those who received comparators were rerandomised to FIL200 or FIL100. This analysis includes week 156 interim results.
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.
View Article and Find Full Text PDFArticle Synopsis
- 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 PDFPurpose: The effect of renal replacement therapy (RRT) in comatose patients with acute kidney injury (AKI) remains unclear. We compared two RRT initiation strategies on the probability of awakening in comatose patients with severe AKI.
Methods: We conducted a post hoc analysis of a trial comparing two delayed RRT initiation strategies in patients with severe AKI.
Objectives: 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.
Background: Recent studies identified coronavirus disease 2019 (COVID-19) as a risk factor for invasive pulmonary aspergillosis (IPA) but produced conflicting data on IPA incidence and impact on patient outcomes. We aimed to determine the incidence and outcomes of COVID-19-associated pulmonary aspergillosis (CAPA) in mechanically ventilated patients.
Methods: We performed a multicenter retrospective observational cohort study in consecutive adults admitted to 15 French intensive care units (ICUs) in 2020 for COVID-19 requiring mechanical ventilation.
Background: Group A Streptococcus is responsible for severe and potentially lethal invasive conditions requiring intensive care unit (ICU) admission, such as streptococcal toxic shock-like syndrome (STSS). A rebound of invasive group A streptococcal (iGAS) infection after COVID-19-associated barrier measures has been observed in children. Several intensivists of French adult ICUs have reported similar bedside impressions without objective data.
View Article and Find Full Text PDFObjectives: 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.
Article Synopsis
- Patients with severe COVID-19 in ICUs have a high risk of blood clots, prompting a study to compare the effects of intermediate-dose versus standard-dose anticoagulation.
- The study included 1,174 patients and found no significant difference in 90-day mortality or ICU stay length between the two dosing groups, but intermediate-dose patients had fewer venous thrombo-embolism (VTE) incidents.
- Both groups experienced similar rates of bleeding complications, indicating that while the doses impacted blood clot rates, they did not affect overall survival or safety.
Introduction: Decontamination regimen decreases acquired infection (ICU-AI) incidence but has remained controversial, mostly because it contains a course of intravenous antibiotic. Multiple-site decontamination (MSD), which does not include systemic antibiotics, has been less widely studied but is associated with lower risks of ventilator-associated pneumonia (VAP), bloodstream infection (BSI) and multidrug resistant micro-organism (MDRO) acquisition. We aimed to confirm these favorable outcomes.
View Article and Find Full Text PDFObjectives: 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.
Background: Spontaneous-breathing trials can be performed with the use of either pressure-support ventilation (PSV) or a T-piece. Whether PSV trials may result in a shorter time to tracheal extubation than T-piece trials, without resulting in a higher risk of reintubation, among patients who have a high risk of extubation failure is unknown.
Methods: In this multicenter, open-label trial, we randomly assigned patients who had a high risk of extubation failure (i.
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.