Publications by authors named "Pascart T"
Objective: To develop and validate a patient-reported definition of acute calcium pyrophosphate (CPP) crystal arthritis in people with crystal-proven CPP deposition (CPPD) disease.
Methods: Consecutive patients with crystal-proven CPPD disease from seven centres across four countries were enrolled in a cross-sectional study. In each centre, patient-reported outcomes on the features of acute CPP crystal arthritis were collected.
Article Synopsis
- The study investigates whether ultrasound detection of monosodium urate crystals can predict the development of symptomatic gout in individuals with elevated urate levels over a five-year period.
- It involves more than 250 participants with asymptomatic hyperuricemia, assessing various health metrics and using ultrasound imaging to monitor the presence of MSU crystal deposition.
- The research is ethically approved and aims to share findings through peer-reviewed publications and conferences.
Article Synopsis
- This study compares two types of transcutaneous neurostimulation (TENS) for treating chronic radicular pain: conventional high-frequency low-intensity current (c-TENS) vs. mixed current (m-TENS), which combines c-TENS with low-frequency high-intensity current.
- Seventy-four patients with chronic neuropathic pain participated in the trial and received both treatments in a randomized order over a month; the primary outcome measured was pain level using a Visual Analog Scale (VAS).
- Results showed no significant difference in pain relief between c-TENS and m-TENS, with similar tolerance levels for both, indicating that there’s no clear preference for either treatment method in managing chronic neuropathic radicular pain.
Article Synopsis
- - Gout is a chronic condition caused by the immune system's reaction to monosodium urate crystals due to high uric acid levels, and recent research sheds light on its inflammatory mechanisms.
- - A large genome-wide association study (GWAS) involving 2.6 million people identified 377 genetic locations linked to gout, with a focus on 149 new loci related to urate and gout inflammation.
- - The study also pinpointed candidate genes influencing the inflammatory response in gout, including those affecting NLRP3 inflammasome activity, and suggests a potential causal role of specific genetic factors in developing the disease.
Sharing genetic and other study results with the communities who participate in research falls under benefit-sharing and capacity-building initiatives that underpin a more equitable biomedical research relationship. Yet, which results to return and how remain fundamental challenges that persist in the absence of practical guidance and institutional policies. Here, we discuss how the return of results can be implemented across different geographies, study designs, and project budgets.
View Article and Find Full Text PDFArticle Synopsis
- - Calcium pyrophosphate deposition disease (CPPD) occurs when CPP crystals build up in joints, triggering inflammation and arthritis, particularly in older individuals over 60, and is linked to cartilage deterioration and osteoarthritis.
- - Common risk factors for CPPD include aging, past joint injuries, and certain metabolic conditions or genetic factors. Diagnosis relies on detecting CPP crystals in joint fluid and imaging techniques like X-rays and ultrasound.
- - Current treatment focuses on managing inflammation since there’s no cure for dissolving CPP crystals; options include prednisone for acute arthritis, low-dose colchicine, and potential use of biologics for stubborn cases.
Article Synopsis
- The review discusses the long-understood but poorly defined pathogenesis of calcium pyrophosphate deposition (CPPD), highlighting the need for deeper research.
- Recent advancements include the 2023 ACR/EULAR classification criteria for CPPD and new imaging techniques, although basic research is lagging behind.
- Emerging methods like Raman spectroscopy and omics sciences may pave the way for better understanding and management of CPPD as it becomes more common in an aging population.
Article Synopsis
- The study aimed to analyze the disease, demographic, and imaging characteristics linked to different types of calcium pyrophosphate deposition (CPPD) disease, focusing on recurrent acute CPP crystal arthritis, chronic CPP crystal inflammatory arthritis, and crowned dens syndrome (CDS).
- Researchers utilized data from an international cohort of 618 individuals to investigate the phenotypic traits of each type of CPPD and performed multivariable logistic regression to assess associations between risk factors and inflammatory phenotypes.
- Key findings indicated that longer disease duration correlated with recurrent acute arthritis, while chronic arthritis was linked to specific joint issues and less associated with metabolic risks, and CDS was more common in males with greater joint involvement. *
Background: Gout is the most common cause of inflammatory arthritis worldwide, particularly in Pacific regions. We aimed to establish the prevalence of gout and hyperuricaemia in French Polynesia, their associations with dietary habits, their comorbidities, the prevalence of the HLA-B*58:01 allele, and current management of the disease.
Methods: The Ma'i u'u survey was epidemiological, prospective, cross-sectional, and gout-focused and included a random sample of adults from the general adult population of French Polynesia.
Article Synopsis
- * The combination of gout and its related conditions leads to higher rates of early death, regardless of typical risk factors like urate levels.
- * SGLT2 inhibitors are promising treatments for gout as they reduce both gout symptoms and associated health risks, while also lowering urate levels and the chances of heart failure and kidney disease.
Objective: Intra-articular (IA) mineralization may contribute to osteoarthritis (OA) structural progression. We studied the association of IA mineralization on knee computed tomography (CT) with cartilage damage worsening on knee magnetic resonance imaging (MRI), with a focus on location- and tissue-specific effects.
Methods: Participants from the Multicenter Osteoarthritis Study with knee CT and MRI scans were included.
Objectives: To determine the clinical associations and predictive value of two thresholds of negative dual-energy CT (DECT) for MSU crystal deposition in gout patients initiating urate lowering therapy (ULT), and identify which threshold is more clinically relevant.
Methods: Patients from the CRYSTALILLE cohort with a diagnosis of gout naive to ULT with baseline DECT scans of knees and feet were selected. Two thresholds of positivity for DECT detection of MSU crystal deposition were considered (<0.
Early-onset gout (EOG) is characterized by the occurrence of the first symptoms of gout at an unusually young age, usually <40 years. The aim of this review is to provide an overview of the epidemiology, clinical presentation and prognosis, association with comorbidities and specific management of EOG. A particularly high proportion of patients with EOG come from ethnic groups with stronger genetic factors, such as populations in the Pacific and Taiwan, who therefore have the highest prevalence of gout overall.
View Article and Find Full Text PDFObjective: To formulate evidence-based recommendations and overarching principles on the use of imaging in the clinical management of crystal-induced arthropathies (CiAs).
Methods: An international task force of 25 rheumatologists, radiologists, methodologists, healthcare professionals and patient research partners from 11 countries was formed according to the EULAR standard operating procedures. Fourteen key questions on the role of imaging in the most common forms of CiA were generated.
A new ex vivo human model of osteoarthritis cartilage calcification.
Rheumatology (Oxford)
January 2024
Objective: Cartilage pathologic calcification is a hallmark of osteoarthritis (OA). Here, we aimed to describe a new ex vivo human model to study the progression of cartilage calcification.
Method: Cartilage explants (n = 11), as well as primary chondrocytes (n = 3), were obtained from OA patients undergoing knee replacement.
Background: Acute calcium pyrophosphate crystal arthritis causes intense joint pain mainly affecting older people. Because guidance and evidence remain scarce, management of this disease relies on expert opinion. We therefore aimed to compare the safety and short-term equivalence of low-dose colchicine with oral prednisone in older patients with acute calcium pyrophosphate crystal arthritis.
View Article and Find Full Text PDFObjective: The EULAR task force recently published the difficult-to-treat RA (D2T RA) definition, however, a definition of D2T axSpA is still lacking and limitations in this definition exist. The objectives were to study the characteristics of D2T axSpA patients using the EULAR definition and to study a subgroup of patients with a predefined more stringent definition including a temporal criterion.
Methods: A multicentric retrospective study was performed.
Objective: To examine factors influencing the kinetics of monosodium urate (MSU) crystal dissolution measured with dual-energy computed tomography (DECT) during follow-up of patients with gout.
Methods: Patients with a diagnosis of gout with baseline knees and feet DECT scans exhibiting MSU crystal volumes ≥0.1 cm and at least one follow-up DECT were included.
Objectives: To assess whether the extent of monosodium urate (MSU) crystal deposition estimated by ultrasound could predict renal and cardiometabolic events during urate-lowering therapy (ULT).
Methods: A prospective study on gout patients from two referral centers initiating ULT who underwent baseline ultrasound and were followed for 1 year. Ultrasound scans assessed six joints for double-contour (DC) signs and tophi.
Article Synopsis
- Calcium pyrophosphate deposition (CPPD) disease is common but previously lacked validated classification criteria, which have now been developed by the American College of Rheumatology (ACR) and EULAR.
- A multinational group established these criteria by generating lists of candidate items, refining definitions, and validating the framework through patient profiles and statistical analysis.
- The new criteria allow for CPPD classification based on specific symptoms, testing results, and a scoring system, demonstrating high sensitivity and specificity in identifying the disease.
Article Synopsis
- Calcium pyrophosphate deposition (CPPD) disease lacks established classification criteria, prompting the American College of Rheumatology (ACR) and EULAR to create the first validated criteria for symptomatic cases.
- A multinational team developed these criteria by analyzing patient profiles, defining candidate items, and employing decision-making methods to establish a scoring system for classification.
- The new criteria showed high sensitivity (92.2% in one cohort; 99.2% in another) and specificity (87.9% and 92.5%, respectively), making them effective tools for diagnosing CPPD disease and advancing research.
Objective: To characterize dual-energy computed tomography (DECT) changes depicting hyaline cartilage changes in gout patients with and without osteoarthritis (OA) and in comparators without gout.
Design: Patients with suspected crystal-associated arthropathy were enrolled and underwent bilateral DECT scans of the knees. Standardized regions of interest were defined in the femorotibial hyaline cartilage.
Objectives: Very little is known on the efficacy and safety of drugs for the management of chronic calcium pyrophosphate (CPP) crystal inflammatory arthritis. The objectives of this work were to describe the drugs used in the management of chronic CPP crystal inflammatory arthritis in expert European centres, and to examine treatment retention.
Methods: This was a retrospective cohort study.
Article Synopsis
- The study evaluated the characteristics of rheumatoid arthritis patients starting Janus Kinase Inhibitors (BARI and TOFA) before and after the VTE risk warnings issued by the European Medicine Agency (EMA).
- It found no significant differences in baseline VTE risk factors for patients initiating these medications before versus after the warnings, although there was a trend towards fewer patients with a history of VTE afterward.
- The persistence rate for using BARI and TOFA over two years was similar, indicating that both medications remained equally effective in the long-term treatment of RA despite VTE concerns.