Publications by authors named "Gottenberg J"
Objectives: To compare two strategies-a hydrocortisone replacement strategy and a prednisone tapering strategy-for their success in glucocorticoid discontinuation in patients with rheumatoid arthritis (RA) with low disease activity (LDA).
Methods: The Strategies for glucocorticoid TApering in Rheumatoid arthritis (STAR) study was a double- blind, double-placebo randomised controlled trial including patients with RA receiving a stable dose of glucocorticoid 5 mg/day for ≥3 months and were in LDA for ≥3 months. Patients were randomly assigned in a 1:1 ratio to either replace prednisone with 20 mg/day of hydrocortisone for 3 months, then reduce to 10 mg/day for 3 months before discontinuation or to taper prednisone by 1 mg/day every month until complete discontinuation, contingent on maintaining LDA.
Objective: This study aimed to assess the impact of Sjögren disease (SjD) on the quality of sexual life and its determinants using the Qualisex questionnaire.
Methods: The Qualisex questionnaire was administered to participants within the ASSESS cohort, a French national multicentric prospective cohort of individuals with SjD. Patients' characteristics and psychometric evaluations were also collected.
The dialogue between T and B cells can be regulated by different mechanisms, such as co-inhibitory receptors, which therefore play a crucial role in preventing autoimmune diseases such as systemic lupus erythematosus (SLE). B and T lymphocyte attenuator (BTLA) is a co-inhibitory receptor expressed on many myeloid and lymphoid cells. Although peripheral B cells express a very high amount of BTLA, previous works in the context of autoimmunity mainly focused on T cells, and whether BTLA expression on B cells plays a role in the lupus pathogenesis is still unclear.
View Article and Find Full Text PDFObjective: To examine the course of interstitial lung disease associated with rheumatoid arthritis (RA-ILD) in France on treatment with Janus kinase inhibitors (JAKis) using the MAJIK-SFR registry.
Methods: Prospective national multicentre observational study identifying patients with RA-ILD from the MAJIK-SFR registry. Pulmonary assessment data were collected at JAKi initiation and follow-up visits (6 months, 12 months and a median of 21 months postinclusion), including chest high-resolution CT (HRCT), pulmonary function tests (forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO)), acute exacerbations of ILD, respiratory infections and lung cancers.
Background: Targeted therapies have been associated with potential risk of malignancy, which is a common concern in daily rheumatology practice in patients with inflammatory arthritis (IA) and a history of cancer.
Objectives: To perform a systematic literature review to inform a Task Force formulating EULAR points to consider on the initiation of targeted therapies in patients with IA and a history of cancer.
Methods: Specific research questions were defined within the Task Force before formulating the exact research queries with a librarian.
Background: Potential associations between targeted therapies and a new cancer in patients with inflammatory arthritis (IA) and a previous malignancy are a frequent concern in daily rheumatology practice.
Objectives: To develop points to consider (PTC) to assist rheumatologists when initiating a targeted therapy in the context of a previous malignancy.
Methods: Following EULAR standardised operating procedures, a task force met to define the research questions for a systematic literature review and to formulate the overarching principles (OPs) and the PTC.
Objective: Recently, three distinct phenotypes of patients with Sjögren disease (SjD) have been described based on cluster analysis: B cell active with low symptoms (BALS), high systemic activity (HSA), and low systemic activity with high symptoms (LSAHS). We aimed to assess whether these clusters were associated with distinct biomarkers and the prognostic value of interferon (IFN) signature.
Methods: The Assessment of Systemic Signs and Evolution in Sjögren's Syndrome cohort is a 20-year prospective cohort of patients with SjD.
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound global impact. The emergence of several variants during the pandemic has presented numerous challenges in preventing and managing this disease. The development of vaccines has played a pivotal role in controlling the pandemic, with a significant portion of the global population being vaccinated.
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- The Newcastle Sjogren's Stratification Tool (NSST) categorizes Sjogren's disease patients into four subtypes, and this study examines how these subtypes change over time and the factors influencing these changes.
- Data from 274 patients in the UKPSSR and 237 in the ASSESS cohort revealed that subtype membership is reasonably stable, with roughly 60% retaining their subtype, particularly the high-symptom burden group.
- Factors such as baseline probability score and certain clinical characteristics, like anti-Ro status and BMI, are linked to subtype stability, suggesting that these symptom-based classifications could reflect underlying disease mechanisms and should be considered in treatment strategies.
Article Synopsis
- A study compared two methods for stopping glucocorticoids in rheumatoid arthritis patients with low disease activity: replacing prednisone with hydrocortisone or tapering prednisone down gradually.
- The trial included 102 patients and found that after 12 months, 55% in the hydrocortisone group and 47% in the tapering group successfully discontinued glucocorticoids, showing no significant difference between the groups.
- The results indicated that neither strategy was superior for achieving discontinuation, and there were no serious side effects related to adrenal insufficiency observed.
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 French Society of Rheumatology updated its recommendations for managing rheumatoid arthritis (RA) based on the latest EULAR guidelines, involving a wide range of experts and patient representatives.
- The guidelines stress the importance of shared decision-making and comprehensive management for individuals with RA or those at risk, focusing on both drug and non-drug therapies.
- Additional emphasis is on the diagnosis and treatment of RA-related interstitial lung disease (RA-ILD), highlighting the need for collaboration between rheumatologists and pulmonologists for effective management.
Article Synopsis
- A web-based ecological momentary assessment (EMA) tool was developed to monitor symptoms in patients with Sjögren's disease (SjD), focusing on daily variability in symptoms over three months.
- The study involved 45 participants, primarily women, who recorded their symptoms through the WebApp, allowing comparisons with traditional paper questionnaires.
- Results showed a high level of user satisfaction (SUS score of 90) and effective symptom tracking, confirming the tool's usefulness for accurately capturing daily experiences of SjD patients.
Introduction: The 1-year PROspective sarilumab (preFILled syringe/pen) multinational, obsErvational (PROFILE) study evaluated the real-world effectiveness and safety of sarilumab in patients with moderate-to-severe rheumatoid arthritis (RA).
Methods: Safety endpoints included adverse events (AEs) and lab abnormalities. Effectiveness endpoints included the ACR core set.
Introduction: The therapeutic interest of targeting B-cell activating factor (BAFF) in Sjögren's disease (SjD) can be suspected from the results of two phase II clinical trials but has not been evaluated in an animal model of the disease. We aimed to evaluate the therapeutic efficacy of this strategy on dryness and salivary gland (SG) infiltrates in the NOD mouse model of SjD.
Material And Methods: Female NOD mice between ages 10 and 18 weeks were treated with a BAFF-blocking monoclonal antibody, Sandy-2 or an isotype control.
Article Synopsis
- Sjögren's disease is an autoimmune condition with a significant risk of developing lymphoma, but effective management strategies for this dual challenge are not well established.
- A study was conducted involving 106 patients who had both Sjögren's disease and lymphoma, focusing on understanding treatment approaches and outcomes related to lymphoma progression and Sjögren's disease symptoms.
- The findings highlighted that mucosa-associated lymphoid tissue lymphoma was the most common type in these patients, and specific factors were analyzed to assess their impact on patients’ prognosis and survival rates.
Fine mapping and bioinformatic analysis of the genetic risk association in Sjögren's Disease (SjD) and Systemic Lupus Erythematosus (SLE) identified five common SNPs with functional evidence in immune cell types: rs4938573, rs57494551, rs4938572, rs4936443, rs7117261. Functional interrogation of nuclear protein binding affinity, enhancer/promoter regulatory activity, and chromatin-chromatin interactions in immune, salivary gland epithelial, and kidney epithelial cells revealed cell type-specific allelic effects for all five SNPs that expanded regulation beyond effects on and expression. Mapping the local chromatin regulatory network revealed several additional genes of interest, including .
View Article and Find Full Text PDFCartilage, an important connective tissue, provides structural support to other body tissues, and serves as a cushion against impacts throughout the body. Found at the end of the bones, cartilage decreases friction and averts bone-on-bone contact during joint movement. Therefore, defects of cartilage can result from natural wear and tear, or from traumatic events, such as injuries or sudden changes in direction during sports activities.
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- Therapeutic monoclonal antibodies have been effective against SARS-CoV-2 in at-risk groups, but their effectiveness is declining due to new variants.
- Health authorities are using in vitro tests to guide treatment recommendations, but these tests may not accurately reflect clinical efficacy in real-world situations.
- A study using hamsters shows that while AZD7442 retains some effectiveness against specific variants like BA.1 and BA.2, its reliability drops significantly against BA.5, underscoring the need for animal studies to enhance understanding of antibody performance in humans.
Objectives: To update the long-term safety profile of filgotinib, a Janus kinase-1 preferential inhibitor, in patients with moderate-to-severe rheumatoid arthritis.
Methods: Data from seven trials were integrated (NCT01888874, NCT01894516, NCT02889796, NCT02873936, NCT02886728, NCT02065700 and NCT03025308). Patients received once-daily filgotinib 100 mg or 200 mg.
Article Synopsis
- Primary Sjögren disease (pSD) is an autoimmune disease that causes dryness in the body and is not yet treatable effectively.
- Researchers studied blood samples from pSD patients to find groups of genes (called Consensus gene Modules) that reveal important information about the disease.
- They discovered that different gene groups could predict how well patients respond to certain treatments, which could help doctors find better ways to help people with pSD in the future.
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)].
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- The study focused on evaluating the correlation and concordance between different activity score indices for Polymyalgia Rheumatica (PMR), particularly including the C reactive protein polymyalgia rheumatica activity score (CRP-PMR-AS).
- Data were analyzed from the SEMAPHORE trial, comparing the efficacy of tocilizumab to placebo in PMR patients while measuring various PMR-ASs at multiple visits.
- Results showed an excellent correlation between the activity scores, indicating that in trials with drugs affecting CRP levels, these derived scores can be reliably used.
Background: Sjögren's disease is a heterogenous autoimmune disease with a wide range of symptoms-including dryness, fatigue, and pain-in addition to systemic manifestations and an increased risk of lymphoma. We aimed to identify distinct subgroups of the disease, using cluster analysis based on subjective symptoms and clinical and biological manifestations, and to compare the prognoses of patients in these subgroups.
Methods: This study included patients with Sjögren's disease from two independent cohorts in France: the cross-sectional Paris-Saclay cohort and the prospective Assessment of Systemic Signs and Evolution of Sjögren's Syndrome (ASSESS) cohort.
Objective: Although airway disease associated with Sjögren's disease (Sjo-AD) is common, it is poorly studied compared with interstitial lung disease (ILD). In this study, we aimed to assess factors associated with Sjo-AD, the characteristics and prognosis of this manifestation.
Methods: We performed a retrospective multicentric study involving nine centres.