Publications by authors named "Jean-Charles Crave"
Article Synopsis
- Long-term adherence to chronic disease treatments is challenging, with only about 50% adherence in developed nations, prompting a need for effective management strategies.
- The study evaluated how satisfaction with the Flexig mHealth application influenced adherence to subcutaneous immunoglobulin therapy among French patients with chronic dysimmune diseases over two years.
- Results showed a high adherence rate of 99.7% linked to good user satisfaction with Flexig, indicating that digital tools can significantly enhance treatment compliance for patients.
The most common peripheral nervous system manifestations in Sjogren's syndrome are small fiber sensory neuropathies (SFPN) and axonal sensorimotor polyneuropathies. Currently, treatment in small fiber neuropathy is mainly symptomatic and based on anti-depressors and anti-epileptics. The benefit of treatment with polyvalent immunoglobulins for SFPN has been reported in small series of patients, although transient in several cases.
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- Immunoglobulins are used as secondary or tertiary treatments for dermatomyositis (DM) and polymyositis (PM) when corticosteroids and immunosuppressants fail, typically administered intravenously once a month or subcutaneously at home a few times a week.
- A study involving seven patients (six with PM and one with DM) explored their experiences with both intravenous immunoglobulins (IVIg) and subcutaneous immunoglobulins (SCIg), revealing varied clinical profiles and significant improvements in symptoms after treatment.
- Patients found SCIg to be more convenient and less disruptive to daily life compared to IVIg, allowing them to regain autonomy and control over their treatment while still being effective and well tolerated.
Article Synopsis
- Immunoglobulin replacement therapy (IgRT) is used in patients with secondary immunodeficiency related to hematological malignancies to help prevent infections, and this study aimed to evaluate its effectiveness and safety.
- In a longitudinal study in France, 160 patients with various types of hematological malignancies were observed for an average of about 8.7 months; results showed an increase in serum immunoglobulin levels and a reduction in infection frequency and severity.
- The study highlighted a diverse range of treatment adherence and management practices among patients, with 38% continuing IgRT without interruption while others had varying degrees of treatment discontinuation.
Immunoglobulin (Ig) therapy is used to treat a wide range of immunodeficiencies and autoimmune diseases; While, its clinical benefit has been demonstrated in several studies, Ig therapy is associated with a risk of systemic adverse effects. As such, Onset of renal impairment, including acute renal failure, osmotic nephrosis and renal insufficiency, after immunoglobulin administration is rare, but is one of the most significant concerns related to intravenous Ig use at immunomodulatory doses. However, only few studies have investigated the safety of subcutaneous Ig (SCIg) in relation to these rare conditions.
View Article and Find Full Text PDFWe reviewed the efficacy of SCIg administration in terms of muscle strength maintenance and patient satisfaction comparing with IVIg in the treatment of auto-immune neuromuscular diseases. A systematic review was conducted, and identified studies from databases (PUBMED, EMBASE, EBSCO, Web of Science and Google Scholar) which were analyzed. The methodological quality of the selected publications was evaluated using the Newcastle-Ottawa Scale.
View Article and Find Full Text PDFPurpose: Subcutaneous immunoglobulin replacement therapy (IgRT) may be administered once a week with a pump or every other day with a syringe (rapid push). The objective of the study was to compare the impact of pump and rapid push infusions on patient's life quality index (LQI).
Methods: This study was a randomized, crossover, multicenter, non-inferiority trial conducted in adults with primary immunodeficiency (PID) accustomed to weekly infusions at home by pump.
Article Synopsis
- The study aimed to outline the characteristics of patients with secondary immunodeficiencies associated with hematological malignancies who began immunoglobulin replacement therapy (IgRT) and examine physicians' expectations regarding this treatment.
- It involved 231 patients mostly suffering from conditions like multiple myeloma and chronic lymphoid leukemia, with a significant portion experiencing recurrent infections and low serum immunoglobulin levels.
- Physicians anticipated that IgRT would prevent infections, improve patients' quality of life, and potentially enhance survival, even considering prophylactic treatment without a prior infection history.
In-depth interviews of patients with primary immunodeficiency who have experienced pump and rapid push subcutaneous infusions of immunoglobulins reveal new insights on their preference and expectations.
Patient Prefer Adherence
March 2018
Article Synopsis
- - Patients with primary immunodeficiency (PID) often receive immunoglobulin replacement therapy (IgRT) via methods like subcutaneous infusions using either an automated pump (P) or manual syringe push (RP), with P being less frequent but longer in duration compared to the more frequent but quicker RP infusions.
- - A study involving interviews with PID patients revealed that while RP is slightly more cost-effective and has similar efficacy to P, many patients preferred P due to better integration into their daily routine and less frequent reminders of their disease.
- - The focus group indicated that the complexity of living with PID influences their delivery method preference, as patients found RP cumbersome and not necessarily time-saving, suggesting that healthcare providers should explore these personal experiences further
Article Synopsis
- Antisynthetase syndrome is a rare and serious disease that affects multiple organs, leading to muscle weakness, lung issues, skin problems, and joint inflammation, typically treated with corticosteroids and immunosuppressants.
- The case study discusses a 56-year-old Algerian woman with multiple drug resistance to traditional treatments, who responded well to subcutaneous immunoglobulin therapy, showing significant improvement in muscle strength and reduced immune deficiency within months.
- This suggests that subcutaneous immunoglobulin treatment could be an effective alternative for patients with hard-to-treat antisynthetase syndrome, offering better compliance and fewer side effects compared to standard therapies.
Introduction: During systemic sclerosis (SSc), peripheral B cells display alterations in subset homeostasis and functional properties and are a promising therapeutic target. However, there is only few data regarding whether these anomalies are accurately reproduced in animal models of SSc.
Objective: In this work, we assessed the B cell homeostasis modifications in an experimental model of SSc [hypochlorous acid (HOCl)-induced mouse], both at a phenotypic and functional level, during the course of the disease.
Subcutaneous immunoglobulin (SCIg) therapy is indicated in primary and secondary immunodeficiency diseases. Its use in practice is being extended to autoimmune diseases. Few studies investigated the feasibility and safety of SCIg in these rare conditions.
View Article and Find Full Text PDFIntroduction: Inclusion body myositis (IBM) is a slowly progressive degenerative inflammatory disorder affecting both proximal and distal muscles. Immunosuppressive therapies are generally ineffective in the treatment of this disorder, and most patients are resistant to steroid therapy. Some benefits with mild improvement were observed with intravenous immunoglobulin (IVIg), particularly in patients with severe dysphagia.
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- Immunoglobulin (IG) therapy is used to treat a variety of diseases, including immunodeficiencies and autoimmune conditions, and can be administered either intravenously or subcutaneously.
- While IG therapy has shown effectiveness in many studies, it can cause a range of adverse reactions, from mild symptoms like headaches and nausea to severe issues such as migraines and renal impairment.
- The paper outlines all potential side effects of IG therapy, offers management guidelines for these reactions, and evaluates the opinions of experts based on evidence categorized using the GRADE system.
Polymyositis is a rare debilitating condition characterized by chronic inflammation and muscle weakness. Standard treatments include corticosteroids and immunosuppressants; however, resistance to these regimens may develop. Intravenous immunoglobulins (IVIg) are thus recommended for patients with drug-resistant polymyositis.
View Article and Find Full Text PDFReversal of Vitamin K Antagonist (VKA) effect in patients with severe bleeding: a French multicenter observational study (Optiplex) assessing the use of Prothrombin Complex Concentrate (PCC) in current clinical practice.
Crit Care
October 2012
Introduction: Prothrombin Complex Concentrate (PCC) is a key treatment in the management of bleeding related to Vitamin K antagonists (VKA). This study aimed to evaluate prospectively PCC use in patients with VKA-related bleeding in view of the French guidelines published in 2008.
Methods: All consecutive patients with VKA-related bleeding treated with a 4-factor PCC (Octaplex®) were selected in 33 French hospitals.