Publications by authors named "Mahevas M"

In an open prospective, multicenter study enrolling 48 selected patients with chronic immune thrombocytopenia who achieved complete response for 1 year on thrombopoietin receptor agonists, half of the patients maintained a sustained response off treatment 4 years after treatment discontinuation.

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  • The decision to choose between thrombopoietin receptor agonists (TPO-RAs) and anti-CD20 for treating immune thrombocytopenia is subjective and depends on individual perspectives.
  • Each treatment has significant benefits and drawbacks that should be considered.
  • Stolz et al. conducted a retrospective analysis, highlighting the need for a larger randomized controlled trial to better compare the efficacy of TPO-RAs and anti-CD20 agents.
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  • Intravenous immunoglobulin (IVIg) is a preferred treatment for severe immune thrombocytopaenia (ITP), but its high cost and limited availability led to specific French guidelines on its use.
  • A study assessed IVIg prescribing practices in real-life situations, evaluating compliance with these French guidelines in a sample of 114 hospitalized patients from 2016 to 2020.
  • Findings showed that 84.4% of IVIg prescriptions were compliant with guidelines, and the use was notably more frequent among younger patients, with factors like corticosteroid resistance and need for surgical preparation influencing non-compliance.
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  • The human immune system continues to develop for several years after birth, affecting how young children respond to infections, such as SARS-CoV-2.
  • Researchers studied T cell responses in children and adults before, during, and after SARS-CoV-2 infection, revealing that younger children (under 5) had a weaker CD4 T cell response compared to older children and adults with mild disease.
  • Following infection, preschool-age children produced similar neutralizing antibodies to adults but had different T cell characteristics and fewer memory B cells, indicating a gradual maturation of their adaptive immune responses.
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  • * Sugammadex can reverse the effects of rocuronium-induced neuromuscular blockade but may also provoke anaphylaxis, indicating a need for better treatment options.
  • * Research into the antibodies of patients with rocuronium sensitivity found a diverse range that can activate anaphylaxis; high-affinity antibodies capable of reversing rocuronium effects were isolated, suggesting new avenues for diagnosis and treatment.
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  • * A study of 120 patients showed that 36% achieved complete cutaneous remission after one year, with oral corticosteroids and a hydroxychloroquine/topical steroids combo yielding the best results.
  • * The findings suggest using hydroxychloroquine and topical steroids as the best first-line treatment due to the negative side effects associated with systemic corticosteroids, with lupus pernio being a predictor of poor response.
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The aim of this study was to assess the prevalence and the burden of difficult-to-treat primary ITP (pITP), defined by the need for another ITP treatment after romiplostim and eltrombopag. Adult patients were selected in the prospective, real-world CARMEN-France registry up to December 2021. Out of 821 adult patients with pITP, 29 had difficult-to-treat ITP (3.

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Background: Adverse pregnancy outcomes in women with primary Sjögren's syndrome have only been evaluated retrospectively using heterogeneous methods and with contradictory results. We aimed to describe adverse pregnancy, delivery, and birth outcome risks in pregnant women with primary Sjögren's syndrome compared with those of a matched general population in France, and to identify factors predictive of disease flares or adverse pregnancy outcomes.

Methods: We conducted a multicentre, prospective, cohort study in France using the GR2 (Groupe de Recherche sur la Grossesse et les Maladies Rares) registry.

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Deficiency in regulatory B cells has been suggested in immune thrombocytopenia. In this study, Stimpson et al. emphasize the importance of considering the treatments received for immunological analyses.

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How infection by a viral variant showing antigenic drift impacts a preformed mature human memory B cell (MBC) repertoire remains an open question. Here, we studied the MBC response up to 6 months after SARS-CoV-2 Omicron BA.1 breakthrough infection in individuals previously vaccinated with three doses of the COVID-19 mRNA vaccine.

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SARS-CoV-2 mRNA vaccination generates protective B cell responses targeting the SARS-CoV-2 spike glycoprotein. Whereas anti-spike memory B cell responses are long lasting, the anti-spike humoral antibody response progressively wanes, making booster vaccinations necessary for maintaining protective immunity. Here, we qualitatively investigated the plasmablast responses by measuring from single cells within hours of sampling the affinity of their secreted antibody for the SARS-CoV-2 spike receptor binding domain (RBD) in cohorts of BNT162b2-vaccinated naive and COVID-19-recovered individuals.

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Combining drugs could be an effective option for treating multirefractory ITP, that is, patients not responding to rituximab, thrombopoietin receptor agonists (TPO-RA) and splenectomy. We conducted a retrospective, multicenter, observational study including multirefractory ITP patients who received a combination of a TPO-RA and an immunosuppressive drug. We included 39 patients (67% women, median age 59 years [range 21-96]), with a median ITP duration of 57 months [3-393] and a median platelet count at initiation of 10 × 10 /L [1-35].

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The emergence of rituximab biosimilars offers the prospect of significant savings to the healthcare system. However, these drugs have never been evaluated for treating immune thrombocytopenia (ITP). This was an observational, matched study.

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  • Immune thrombocytopenia (ITP) is a bleeding disorder caused by autoantibodies from plasma cells, leading to challenges in treatment for some patients.
  • In refractory cases, long-lived autoreactive plasma cells in the spleen and bone marrow can hinder the effectiveness of treatments like rituximab and splenectomy.
  • New treatment strategies are focusing on targeting B cells and plasma cells to prevent relapse and improve patient outcomes, including combinations of existing therapies and alternative strategies to block the effects of autoantibodies.
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Sustained response off treatment (SROT) after thrombopoietin receptor agonist (TPO-RA) discontinuation has been reported in immune thrombocytopenia (ITP). This prospective multicenter interventional study enrolled adults with persistent or chronic primary ITP and complete response (CR) on TPO-RAs. The primary end point was the proportion of patients achieving SROT (platelet count >30 × 109/L and no bleeding) at week 24 (W24) with no other ITP-specific medications.

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Many epidemiological studies have shown that the incidence of immune thrombocytopenia (ITP) increases after age 60 years and peaks in patients over age 80 years. Therefore, ITP is a concern for physicians taking care of older patients, especially regarding its diagnosis and management. The diagnostic work-up should exclude other causes of thrombocytopenia and secondary ITP, including myelodysplastic syndrome and drug-induced ITP.

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Introduction: Sarcoidosis is a systemic granulomatosis of unknown etiology, characterized by the presence of immune granulomas. Liver damage is a relatively common extra-pulmonary manifestation, occurring in 3.6-30% of cases.

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Therapeutic antibodies have broad indications across diverse disease states, such as oncology, autoimmune diseases, and infectious diseases. New research continues to identify antibodies with therapeutic potential as well as methods to improve upon endogenous antibodies and to design antibodies de novo. On April 27-30, 2022, experts in antibody research across academia and industry met for the Keystone symposium "Antibodies as Drugs" to present the state-of-the-art in antibody therapeutics, repertoires and deep learning, bispecific antibodies, and engineering.

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  • * Researchers examined SARS-CoV-2 naive patients with specific genetic deficiencies and autoantibodies that affect IFN response to see if this impacted vaccine efficacy.
  • * The study found that despite these deficiencies, the B cell response, including memory B cells and IgG production, remained robust and similar to healthy individuals, indicating type I IFN isn't essential for generating a strong vaccine-induced immune response against SARS-CoV-2.
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