107 results match your criteria: "National Referral Center for Rare Systemic Autoimmune Diseases[Affiliation]"

Background: The PEXIVAS (Plasma exchange and glucocorticoids in severe antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis) trial showed that a reduced-dose glucocorticoid regimen (redGC) was non-inferior to a standard-dose regimen (standGC) with respect to death or end-stage kidney disease (ESKD) in patients with ANCA-associated vasculitis (AAV). However, the primary endpoint did not include disease progression or relapse, cyclophosphamide was the main induction therapy and rituximab (RTX)-treated patients tended to have a higher risk of death or ESKD with redGC. We aimed to evaluate the real-world use of redGC.

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Data-driven subclassification of ANCA-associated vasculitis: model-based clustering of a federated international cohort.

Lancet Rheumatol

November 2024

Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden; Department of Medicine, University of Cambridge, Cambridge, UK.

Background: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a heterogenous autoimmune disease. While traditionally stratified into two conditions, granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), the subclassification of ANCA-associated vasculitis is subject to continued debate. Here we aim to identify phenotypically distinct subgroups and develop a data-driven subclassification of ANCA-associated vasculitis, using a large real-world dataset.

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Update on targeted treatments for ANCA-associated vasculitis.

Joint Bone Spine

July 2024

National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance publique-Hôpitaux de Paris (AP-HP).Centre, Université Paris Cité, Paris, France; Institut Cochin, Inserm U1016, CNRS UMR 8104, Paris, France; French Vasculitis Study Group, Hôpital Cochin, Paris, France. Electronic address:

Targeted therapy has revolutionized the management of ANCA-associated vasculitis (AAV) over the last fifteen years. Rituximab, an approved induction and maintenance agent for severe AAV, is no less effective than cyclophosphamide as induction therapy and particularly useful in relapsing or refractory disease, or in women. In patients with relapsing AAV, granulomatosis with polyangiitis or PR3-ANCA, it is more effective than cyclophosphamide.

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Large-vessel involvement in ANCA-associated vasculitis: A multicenter case-control study.

Semin Arthritis Rheum

August 2024

Médecine Interne, Centre Hospitalier Universitaire Gabriel-Montpied, 63000 Clermont-Ferrand, France; Université Clermont Auvergne Inserm U1071, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), USC-INRA 2018, Clermont-Ferrand, France. Electronic address:

Objective: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) primarily affects small vessels. Large-vessel involvement (LVI) is rare. We aimed to describe the characteristics of LVI, to identify associated risk factors, and to describe its therapeutic management.

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Article Synopsis
  • Patients with X linked agammaglobulinemia and those receiving anti-CD20 monoclonal antibodies (mAbs) for immune-mediated inflammatory diseases (IMIDs) are at increased risk for severe enterovirus (EV) infections, particularly meningoencephalitis.
  • A study collected data from nine original cases and 17 previously published cases, revealing a high occurrence of meningoencephalitis (81%) and a mortality rate of 27% among affected patients treated with multiple anti-CD20 mAbs.
  • The findings suggest that clinicians should consider EV infections in IMID patients presenting unusual symptoms and recognize that anti-CD20 mAbs can impair B-cell responses to EV infections, potentially indicating
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Benralizumab versus Mepolizumab for Eosinophilic Granulomatosis with Polyangiitis.

N Engl J Med

March 2024

From the Department of Medicine, National Jewish Health, Denver (M.E.W.); McMaster University and St. Joseph's Healthcare, Hamilton, ON, Canada (P.N.); the Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, and Université Paris Cité, Paris (B.T.), and the Department of Respiratory Diseases, University of Montpellier, Centre Hospitalier Universitaire Montpellier, INSERM, Centre National de la Recherche Scientifique, Montpellier (A.B.) - all in France; the Department of Internal Medicine, Rheumatology, and Immunology, Medius Kliniken, University of Tübingen, Kirchheim-Teck, Germany (B.W.); the Department of Medicine, University of Cambridge (D.R.W.J.), and BioPharmaceuticals Medical (A.S.) and Late-Stage Respiratory and Immunology, BioPharmaceuticals Research and Development (C.W.), AstraZeneca, Cambridge, and Guy's Severe Asthma Centre, School of Immunology and Microbial Sciences, King's College London, London (D.J.J.) - all in the United Kingdom; the Department of Internal Medicine, Hôpital Erasme, Université Libre de Bruxelles, Brussels (F.R.); Late-Stage Respiratory and Immunology, BioPharmaceuticals Research and Development, AstraZeneca, Gothenburg, Sweden (L.B.S., S.N.); Late-Stage Respiratory and Immunology, BioPharmaceuticals Research and Development (Y.F., M.J.), and Translational Science and Experimental Medicine, Early Respiratory and Immunology, BioPharmaceuticals Research and Development (C.M.), AstraZeneca, Gaithersburg, MD; and the Division of Rheumatology, Department of Medicine, and the Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia (P.A.M.).

Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a vasculitis characterized by eosinophilic inflammation. Benralizumab, a monoclonal antibody against the interleukin-5α receptor expressed on eosinophils, may be an option for treating EGPA.

Methods: We conducted a multicenter, double-blind, phase 3, randomized, active-controlled noninferiority trial to evaluate the efficacy and safety of benralizumab as compared with mepolizumab.

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Background And Objectives: In SSc, ILD is a major cause of morbidity and mortality. We aimed to investigate the performance of DLCO (diffusing capacity of lung carbon monoxide) and FVC (forced vital capacity) delta change (Δ) and baseline values in predicting the development of SSc-ILD.

Methods: Longitudinal data of DLCO, FVC, and ILD on the HRCT of SSc patients from the EUSTAR database were evaluated at baseline (t) and after 12 (±4) (t) and 24 (±4) (t) months.

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Purpose: Severe asthma affects 5 to 10% of asthmatics and accounts for a large part of asthma-related morbidity and costs. The determinants of asthma severity are poorly understood. We tested the hypothesis that asthma severity was associated with 1) atopy and allergy and 2) markers associated with environmental exposure.

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Objectives: Adult IgA vasculitis (IgAV) is more common in males, but the potential impact of gender remains unclear. We aimed to describe the impact of gender on presentation and outcome in adult IgAV.

Methods: We retrospectively analysed data from a multicentre retrospective cohort of 260 patients (IGAVAS).

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Objectives: This study aims to describe the data structure and harmonisation process, explore data quality and define characteristics, treatment, and outcomes of patients across six federated antineutrophil cytoplasmic antibody-associated vasculitis (AAV) registries.

Methods: Through creation of the vasculitis-specific Findable, Accessible, Interoperable, Reusable, VASCulitis ontology, we harmonised the registries and enabled semantic interoperability. We assessed data quality across the domains of uniqueness, consistency, completeness and correctness.

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Article Synopsis
  • The study aimed to determine if serum calprotectin levels could predict declines in kidney function among patients with ANCA-associated vasculitis (AAV) undergoing maintenance therapy.
  • Serum calprotectin levels were measured at the start and after 6 months in patients in remission, and an increase was linked to a higher risk of significant renal function decline and relapse of the disease.
  • The findings suggest that monitoring calprotectin levels could be important for identifying patients at risk of worsening kidney function in the following year.
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Targeting the chemokine receptor CXCR4 with histamine analog to reduce inflammation in juvenile arthritis.

Front Immunol

October 2023

Centre National de la Recherche Scientifique (CNRS) Unité Mixte de Recherche (UMR)-8601, Université Paris Cité, Paris, France.

Article Synopsis
  • Activated monocytes contribute to chronic inflammatory diseases like Juvenile Idiopathic Arthritis (JIA), causing damage to joints and highlighting a need for new treatment strategies.
  • The study investigated the histamine analog clobenpropit (CB) as a potential therapy targeting the CXCR4 receptor on monocytes, showing it reduces the production of inflammatory cytokines in both JIA patients and arthritic mice.
  • CB treatment led to significant improvements in mouse models, decreasing inflammation and joint damage, suggesting it could be a promising therapeutic option alongside current treatments for rheumatoid arthritis.
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Invasive fungal diseases in patients with autoimmune diseases: a case series from the French RESSIF network.

RMD Open

August 2023

National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Cochin Hospital, AP-HP, Université Paris Cité, Paris, Île-de-France, France.

Objectives: We aimed to describe patients with autoimmune diseases (AID) developing invasive fungal disease (IFD) and identify factors associated with short-term mortality.

Methods: We analysed cases of IFD associated with AID from the surveillance network of invasive fungal diseases (Réseau de surveillance des infections fongiques invasives, RESSIF) registry of the French national reference centre for invasive mycoses. We studied association of AID-specific treatments with 30-day mortality.

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Benralizumab for eosinophilic granulomatosis with polyangiitis.

Ann Rheum Dis

December 2023

Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France

Background: Benralizumab is effective in the treatment of eosinophilic asthma and is being investigated for the treatment of other eosinophil-associated diseases. Reports on the use of benralizumab for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) are limited to case reports and small case series.

Methods: We conducted a multicentre, retrospective study including EGPA patients treated with off-label benralizumab.

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Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, characterized by asthma, eosinophilia and granulomatous or vasculitic involvement of several organs. The diagnosis and management of EGPA are often challenging and require an integrated, multidisciplinary approach. Current practice relies on recommendations and guidelines addressing the management of ANCA-associated vasculitis and not specifically developed for EGPA.

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Association Between Plasma Rituximab Concentration and the Risk of Major Relapse in Antineutrophil Cytoplasmic Antibody-Associated Vasculitides During Rituximab Maintenance Therapy.

Arthritis Rheumatol

November 2023

Department of Pharmacokinetics and Pharmacochemistry, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, and Université Paris Cité, UMR8038 CNRS, U1268 INSERM, Faculté de Pharmacie, PRES Sorbonne Paris Cité, CARPEM, Paris, France.

Objective: Interindividual variability in response to rituximab remains unexplored in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides. Rituximab pharmacokinetics (PK) and pharmacodynamics (PD) as well as genetic polymorphisms could contribute to variability. This ancillary study of the MAINRITSAN 2 trial aimed to explore the relationship between rituximab plasma concentration, genetic polymorphisms in PK/PD candidate genes, and clinical outcomes.

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Finger ischaemia, enlarged spleen and lung nodules.

Ann Rheum Dis

December 2023

National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France.

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Objective: To develop a score assessing the probability of relapse in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA).

Methods: Long-term follow-up data from GPA and MPA patients included in five consecutive randomised controlled trials were pooled. Patient characteristics at diagnosis were entered into a competing-risks model, with relapse as the event of interest and death the competing event.

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Proteinuria and hematuria after remission induction are associated with outcome in ANCA-associated vasculitis.

Kidney Int

June 2023

Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France; Department of Medicine, Université de Paris, Paris, France.

In anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), hematuria and proteinuria are biomarkers reflecting kidney involvement at diagnosis. Yet, the prognostic value of their persistence after immunosuppressive induction therapy, reflecting kidney damage or persistent disease, remains uncertain. To study this, our post hoc analysis included participants of five European randomized clinical trials on AAV (MAINRITSAN, MAINRITSAN2, RITUXVAS, MYCYC, IMPROVE).

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Background: Since the publication of the EULAR recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in 2016, several randomised clinical trials have been published that have the potential to change clinical care and support the need for an update.

Methods: Using EULAR standardised operating procedures, the EULAR task force undertook a systematic literature review and sought opinion from 20 experts from 16 countries. We modified existing recommendations and created new recommendations.

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Introduction: ANCA-associated vasculitis (AAV) is an exceptional cause of small and large vascular aneurysms. Here, we present the phenotypic characteristics of patients with AAV associated with the presence of aneurysms.

Methods: We conducted a retrospective multicenter study and a systematic review of the literature.

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Differentiation between Whipple disease (WD) patients and patients carrying Tropheryma whipplei but suffering from disease other than WD ("carriers") remains complex. We aimed to evaluate T. whipplei PCR among patients with WD and carriers in a large cohort at our referral clinical microbiology laboratory.

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Background: Primary angiitis of the central nervous system (PACNS) is a rare disease, for which no validated guidelines exist. We report the findings of a survey on the clinical practice of physicians who manage adults with PACNS.

Methods: An online survey was distributed through neurology, internal medicine, and rheumatology societies in Canada and Europe.

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Rituximab vs Cyclophosphamide Induction Therapy for Patients With Granulomatosis With Polyangiitis.

JAMA Netw Open

November 2022

National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP) Centre, Université Paris Cité, Paris, France.

Importance: Results of randomized clinical trials have demonstrated rituximab's noninferiority to cyclophosphamide as induction therapy for antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV), with neither treatment having a specific advantage for granulomatosis with polyangiitis (GPA). However, post hoc analysis results have suggested that rituximab might be more effective than cyclophosphamide in inducing remission in patients with proteinase 3-positive AAV.

Objective: To compare the effectiveness of rituximab and cyclophosphamide in inducing GPA remission in a large population of unselected patients.

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