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Spinal Diseases: HELP
Articles by Martin Soubrier
Based on 25 articles published since 2009
(Why 25 articles?)
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Between 2009 and 2019, M. Soubrier wrote the following 25 articles about Spinal Diseases.
 
+ Citations + Abstracts
1 Guideline EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. 2010

Peters, M J L / Symmons, D P M / McCarey, D / Dijkmans, B A C / Nicola, P / Kvien, T K / McInnes, I B / Haentzschel, H / Gonzalez-Gay, M A / Provan, S / Semb, A / Sidiropoulos, P / Kitas, G / Smulders, Y M / Soubrier, M / Szekanecz, Z / Sattar, N / Nurmohamed, M T. ·Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands. ·Ann Rheum Dis · Pubmed #19773290.

ABSTRACT: OBJECTIVES: To develop evidence-based EULAR recommendations for cardiovascular (CV) risk management in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA). METHODS: A multidisciplinary expert committee was convened as a task force of the EULAR Standing Committee for Clinical Affairs (ESCCA), comprising 18 members including rheumatologists, cardiologists, internists and epidemiologists, representing nine European countries. Problem areas and related keywords for systematic literature research were identified. A systematic literature research was performed using MedLine, Embase and the Cochrane library through to May 2008. Based on this literature review and in accordance with the EULAR's "standardised operating procedures", the multidisciplinary steering committee formulated evidence-based and expert opinion-based recommendations for CV risk screening and management in patients with inflammatory arthritis. RESULTS: Annual CV risk assessment using national guidelines is recommended for all patients with RA and should be considered for all patients with AS and PsA. Any CV risk factors identified should be managed according to local guidelines. If no local guidelines are available, CV risk management should be carried out according to the SCORE function. In addition to appropriate CV risk management, aggressive suppression of the inflammatory process is recommended to further lower the CV risk. CONCLUSIONS: Ten recommendations were made for CV risk management in patients with RA, AS and PsA. The strength of the recommendations differed between RA on the one hand, and AS and PsA, on the other, as evidence for an increased CV risk is most compelling for RA.

2 Review [Cardiovascular risk in ankylosing spondylitis]. 2015

Mathieu, Sylvain / Soubrier, Martin. ·CHU de Clermont-Ferrand, service de rhumatologie, 63000 Clermont-Ferrand, France. Electronic address: smathieu@chu-clermontferrand.fr. · CHU de Clermont-Ferrand, service de rhumatologie, 63000 Clermont-Ferrand, France. ·Presse Med · Pubmed #26248709.

ABSTRACT: An increased cardiovascular risk has been consistently reported in inflammatory rheumatic diseases. An important number of studies found the same higher cardiovascular risk in rheumatoid arthritis and systemic lupus erythematosus. On the contrary, the presence of this increase cardiac risk is less documented in ankylosing spondylitis (AS) with some contradictory information in the studies. This review aims to report the current data in 2014 on the high cardiovascular risk in AS, the prevalence of cardiovascular risk factors in this rheumatic disease, the cardiovascular effects of treatment and the guidelines for cardiovascular risk management.

3 Review Cardiovascular profile in ankylosing spondylitis: a systematic review and meta-analysis. 2011

Mathieu, Sylvain / Gossec, Laure / Dougados, Maxime / Soubrier, Martin. ·Clermont 1 University, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France. smathieu@chu-clermontferrand.fr ·Arthritis Care Res (Hoboken) · Pubmed #20890982.

ABSTRACT: OBJECTIVE: Rheumatoid arthritis is associated with increased cardiovascular risk. In ankylosing spondylitis (AS), there is a paucity of information concerning this risk. Our objective was to assess the incidence of myocardial infarction (MI) or strokes and the cardiovascular risk profile in AS patients. METHODS: We performed a systematic literature review using PubMed, EMBase, and the Cochrane Library up to August 2009. Incidence of MI or stroke was calculated by metaproportion. For cardiovascular risk factors, differences between AS patients and controls were expressed by standardized mean differences using inverse of variance method. RESULTS: For MI, 8 longitudinal studies were included. In controls (n=82,745), 1,318 MI cases were observed (4.6%; 95% confidence interval [95% CI] 1.2%, 10.0%). In AS patients (n=3,279), 224 MI cases were reported (incidence 7.4%; 95% CI 5.2%, 10.0%). The increase in MI cases in AS patients was not significant (risk ratio 1.88; 95% CI 0.83, 4.28). For stroke, 7 longitudinal studies reported 327 strokes in AS patients (n=31,949), which is an incidence of 2.2% (95% CI 1.3%, 3.4%). In controls (n=7,372), one study reported 170 strokes (2.3%; 95% CI 2.0%, 2.7%). For cardiovascular risk factors, 15 case-control studies and 9 abstracts were included (n=1,214 for patients and n=1,000 for controls). AS patients were characterized by a higher weighted mean intima-media thickness and higher risk of metabolic syndrome. In AS patients, there was a significant decrease in triglycerides, total cholesterol, and high-density lipoprotein (HDL) cholesterol. CONCLUSION: AS patients appear to be at higher risk of MI, which could be due to low HDL cholesterol levels or to systemic inflammation. Management of cardiovascular risk factors and control of systemic inflammation should be taken into account in AS.

4 Review Spondyloarthropathies: an independent cardiovascular risk factor? 2010

Mathieu, Sylvain / Motreff, Pascal / Soubrier, Martin. ·Service de rhumatologie, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France. smathieu11@yahoo.fr ·Joint Bone Spine · Pubmed #20646947.

ABSTRACT: An increase in cardiovascular mortality and morbidity has been convincingly documented in rheumatoid arthritis. Data on spondyloarthropathies are more limited. Here, we discuss published studies indicating that patients with spondyloarthropathies are at increased risk for cardiovascular disease. The excess risk is probably multifactorial, being related both to chronic systemic inflammation and to high prevalences of conventional cardiovascular risk factors. Cardiovascular risk management in patients with spondyloarthropathies requires optimal control of disease activity combined with interventions targeting conventional cardiovascular risk factors.

5 Clinical Trial Efficacy and safety of pamidronate in Modic type 1 changes: study protocol for a prospective randomized controlled clinical trial. 2014

Cecchetti, Stella / Pereira, Bruno / Roche, Antoine / Deschaumes, Christophe / Abdi, Dihya / Coudeyre, Emmanuel / Dubost, Jean-Jacques / Mathieu, Sylvain / Malochet-Guinamand, Sandrine / Tournadre, Anne / Couderc, Marion / Vayssade, Marielle / Daron, Coline / Soubrier, Martin. ·Rheumatology Department, Clermont-Ferrand University Hospital, G Montpied Hospital, 58 Montalembert Street, F-63003 Clermont-Ferrand, France. msoubrier@chu-clermontferrand.fr. ·Trials · Pubmed #24716739.

ABSTRACT: BACKGROUND: Erosive degenerative disc disease, also known as Modic type 1 changes, is usually characterized by low back pain with an inflammatory pain pattern, as seen in spondyloarthropathies. Intravenous pamidronate has proven to be effective in patients with ankylosing spondylitis who are refractory to nonsteroidal antiinflammatory drugs, and in painful bone diseases in general, such as Paget's disease, fibrous dysplasia or vertebral fractures. We therefore hypothesize that pamidronate would be effective in treating low back pain associated with Modic type 1 changes. METHODS/DESIGN: This study, called PEPTIDE (short for the French title "Etude Prospective sur l'Efficacité et la tolérance du PamidronaTe dans les dIscopathies Degeneratives Erosives"), will be a double-blind, randomized, placebo-controlled, parallel group, phase two clinical trial. A total of 48 patients will be recruited. These patients will be randomly assigned to one of the two groups, with 24 patients in each group: one group will be given pamidronate and the other a placebo. Pamidronate will be administered at a dose of 90 mg per day for two days consecutively, and every patient, irrespective of treatment group, will be given paracetamol to maintain blinding by preventing drug-induced fever. The primary outcome measure is a between-group difference of 30 points on a 100 mm Visual Analogue Scale (VAS) at three months. Secondary outcome measures are improvement in functional status and the drug's safety. Primary and secondary outcome measures will be assessed at each visit (inclusion, at six weeks, three months, and six months). If the primary goal is not attained, the patient will be offered a rigid or semi-rigid back brace, irrespective of the treatment group. DISCUSSION: To date, only local treatments, for example intradiscal corticosteroid therapy, lumbar arthrodesis or back braces have been studied in randomized, controlled trials, with controversial results. This trial is currently ongoing and, if conclusive, should provide physicians with an acceptable alternative to those treatments. The results should be publicly available in spring 2015. TRIAL REGISTRATION: ClinicalTrials.gov number, NCT01799616.

6 Article Evaluation of the impact of concomitant fibromyalgia on TNF alpha blockers' effectiveness in axial spondyloarthritis: results of a prospective, multicentre study. 2018

Moltó, Anna / Etcheto, Adrien / Gossec, Laure / Boudersa, Nadia / Claudepierre, Pascal / Roux, Nicolas / Lemeunier, Lucie / Martin, Antoine / Sparsa, Lartitia / Coquerelle, Pascal / Soubrier, Martin / Perrot, Serge / Dougados, Maxime. ·Rheumatology Department, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France. · Department of INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France. · Rheumatology Department, Sorbonne Universités, UPMC Univ Paris, Hôpital Pitié Salpêtrière, AP-HP, Paris, France. · Rheumatology Department, Dr Benbadis University Hospital, Constantine, Algeria. · Department of Rheumatology, AP-HP, CHU Henri Mondor, Université Paris Est Créteil, Créteil, France. · Rheumatology Department, Hôpital de Metz, Metz, France. · Rheumatology Department, Saint Antoine Hospital, APHP, Paris, France. · Dermatology and Rheumatology Department, Saint Brieuc Hospital, Saint Brieuc, France. · Rheumatology Department, Mulhouse Hospital, Groupe hospitalier de Mulhouse et Sud Alsace, Mulhouse, France. · Rheumatology, Nephrology and Endocrinology Department, Hôpital de Bethune, Bethune, France. · Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France. · Department of Pain Center and INSERM U987, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France. ·Ann Rheum Dis · Pubmed #29183878.

ABSTRACT: OBJECTIVE: To describe the prevalence of fibromyalgia (FM) in an axial spondyloarthritis (axSpA) population and to confirm that concomitant FM had a negative impact on tumour necrosis factor blockers' (TNFb) response. DESIGN: Prospective observational study with two visits 3 months apart. PATIENTS: Adult patients with AxSpa initiating a TNFb. STUDY GROUPS: FM was defined by the Fibromyalgia Rapid Screening Tool (FiRST) at baseline and also by a sustained positive FiRST (both visits) and by a fulfilment of the 1990 American College of Rheumatology criteria for FM. STATISTICAL ANALYSIS: Prevalence of FM; evaluation of the impact of a concomitant FM on TNFb response (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI 50) as primary endpoint), adjusted by factors known to have an impact on TNFb response. RESULTS: Among the 508 patients included in the main analysis, 192 (37.8%) were screened at baseline as FM. Percentage of success after 12 weeks of treatment was lower in the FM group for most of the effectiveness endpoints (eg, BASDAI 50: 45.3% vs 54.1% in the FM/not FM groups according to the FiRST), except for the C reactive protein change endpoints which were not different across groups. CONCLUSION: This study confirms that FM coexists in patients with axSpA and that its presence seems to have a negative impact on TNFb response, which seems more related to the self-reported instruments used in its evaluation, rather than a different treatment effect of the molecule in this subgroup of patients.

7 Article Characteristics of spontaneous coagulase-negative staphylococcal spondylodiscitis: a retrospective comparative study versus Staphylococcus aureus spondylodiscitis. 2017

Lopez, Julien / Tatar, Zuzana / Tournadre, Anne / Couderc, Marion / Pereira, Bruno / Soubrier, Martin / Dubost, Jean-Jacques. ·Department of Rheumatology, University Hospital Gabriel Montpied, 58 rue Montalembert, 63003, Clermont Ferrand CEDEX 1, France. · Biostatistics Unit, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. · Department of Rheumatology, University Hospital Gabriel Montpied, 58 rue Montalembert, 63003, Clermont Ferrand CEDEX 1, France. jjdubost@chu-clermontferrand.fr. ·BMC Infect Dis · Pubmed #29029624.

ABSTRACT: BACKGROUND: Coagulase-negative staphylococci (CoNS) are increasingly implicated in recent patient series of spondylodiscitis, but there are no series of CoNS-spondylodiscitis available. The objective of this study was to compare the characteristics of patients with spontaneous CoNS-spondylodiscitis with those patients with Staphylococcus aureus (SA) spondylodiscitis. METHODS: This was a retrospective single center study involving 147 spontaneous infectious spondylodiscitis cases observed between 2000 and 2015. The 26 cases of CoNS-spondylodiscitis (15 confirmed) were compared with 30 cases of SA-spondylodiscitis. CoNS infection was considered confirmed if the same CoNS was isolated in at least two samples at two different times. RESULT: Patients with CoNS-spondylodiscitis were older (70 vs. 61 years of age; p = 0.01), had associated cancer more often (15% vs. 0%; p = 0.04) and had a longer diagnostic delay (>15 days in 88% vs. 60%; p = 0.01); experienced fever less often (19% vs. 50%; p = 0.01), and had lower white blood cell (7.6 vs. 9.9G/L; p = 0.01) and polymorphonuclear leucocyte counts (5.6 vs. 7.5G/L; p = 0.04). Patients with CoNS spondylodiscitis had less pronounced inflammatory syndrome (erythrocyte sedimentation rate [ESR]: 62 vs. 81 mm at 1 h; p = 0.03; CRP: 60 vs. 147 mg/L; p = 0.0003) and less common (ESR < 30 mm: 23% vs. 0%; p = 0.01; CRP < 10 mg/L: 23% vs. 0%; p = 0.005) in comparison with patients with SA infection. The infection entry site was most often an intravascular catheter (20% vs. 3%; p = 0.008). The level of positive percutaneous needle biopsies was comparable between CoNS and SA. Two patients who died both had SA infections. CONCLUSION: CoNS-spondylodiscitis involved at least 10% of spontaneous spondylodiscitis cases and was more common in elderly patients, afflicted by comorbidities, and its presentation was less virulent than that of those with SA-spondylodiscitis.

8 Article Prevalence and risk factors of low bone mineral density in spondyloarthritis and prevalence of vertebral fractures. 2017

Malochet-Guinamand, Sandrine / Pereira, Bruno / Tatar, Zuzana / Tournadre, Anne / Moltó, Anna / Dougados, Maxime / Soubrier, Martin. ·Rheumatology Department, Clermont-Ferrand University Hospital, 58 Rue Montalembert, FR 63003, Clermont-Ferrand, France. smalochet@chu-clermontferrand.fr. · Biostatistics unit (Clinical Research Direction), University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France. · Rheumatology Department, Clermont-Ferrand University Hospital, 58 Rue Montalembert, FR 63003, Clermont-Ferrand, France. · Rheumatology Department, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France. ·BMC Musculoskelet Disord · Pubmed #28830392.

ABSTRACT: BACKGROUND: Investigate the prevalence and risk factors of low bone mineral density (BMD) in patients with axial spondyloarthritis as well as investigating the prevalence of vertebral fractures. METHODS: Patients underwent BMD measurements with dual-energy X-ray absorptiometry (DXA) in the anterior-posterior lumbar spine, lateral spine and hip. We screened for vertebral fractures using vertebral fracture assessment, and then checked for syndesmophytes on the VFA images. Sociodemographic and clinical variables were collected. RESULTS: A total of 89 patients (41,6% female) took part in the study with a mean age of 44 ± 14 years and disease duration 10.2 ± 10.6 years. According to World Health Organization (WHO) criteria, 48,3% of patients displayed osteopenia and 6,7% osteoporosis. In the subgroup of women who underwent measurement at all sites including the lateral spine, the prevalence of osteopenia was 39.3% in the anterior-posterior spine, 32.1% in the lateral spine, and 64.3% with all sites together. VFA led to the diagnosis of at least one vertebral fracture in 6.2% of patients. On VFA, syndesmophytes were found in 24.3% of patients. The variables associated in multivariate analyses with low BMD in different measurement sites were low body mass index (BMI), a high physician's global assessment score, a high Bath Ankylosing Spondylitis Functional Index (BASFI) score and female gender. CONCLUSION: Our study found a high prevalence (around 50%) of low BMD in SpA. Conversely, the prevalence of osteoporosis (6.7% according to WHO criteria) and vertebral fractures (6.2%) was lower than generally reported in the literature. While lateral spine BMD measurement did little to improve the detection of osteopenia in women, the sample size was not large enough to enable us to draw definite conclusions.

9 Article Takayasu Arteritis and Spondyloarthritis: Coincidence or Association? A Study of 14 Cases. 2017

Rivière, Elodie / Arnaud, Laurent / Ebbo, Mikael / Allanore, Yannick / Claudepierre, Pascal / Dernis, Emmanuelle / Ziza, Jean-Marc / Miceli-Richard, Corinne / Philippe, Peggy / Richez, Christophe / Soubrier, Martin / Belkhir, Rakiba / Seror, Raphaèle / Mariette, Xavier / Pavy, Stephan / Anonymous4810903. ·From the Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, Le Kremlin Bicêtre; INSERM UMR-S 1136, Hôpital Pitié-Salpêtrière; Rheumatology A Department, Hôpital Cochin, University Paris Descartes; Rheumatology, Groupe Hospitalier Diaconesses Croix Saint Simon; Rheumatology Department B, Hôpital Cochin, Paris; Internal Medicine, Centre Hospitalier Universitaire (CHU) Timone, Aix Marseille Université, Marseille; Rheumatology, CHU H. Mondor, Créteil; Rheumatology, Centre hospitalier Le Mans; Rheumatology, Hôpital Salengro, Lille; Rheumatology, GH Pellegrin, Bordeaux; Rheumatology, CHU Gabriel Montpied, Clermont Ferrand, France. · E. Rivière, MD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud; L. Arnaud, MD, PhD, INSERM UMR-S 1136, Hôpital Pitié-Salpêtrière; Rheumatology A Department, Hôpital Cochin, University Paris Descartes; M. Ebbo, MD, Internal Medicine, CHU Timone, Aix Marseille Université; Y. Allanore, MD, PhD, Rheumatology A Department, Hôpital Cochin, University Paris Descartes; P. Claudepierre, MD, Rheumatology, CHU H. Mondor; E. Dernis, MD, Rheumatology, Centre hospitalier Le Mans; J.M. Ziza, MD, Rheumatology, Groupe Hospitalier Diaconesses Croix Saint Simon; C. Miceli-Richard, MD, PhD, Rheumatology, Department B, Hôpital Cochin; P. Philippe, MD, Rheumatology, Hôpital Salengro; C. Richez, MD, PhD, Rheumatology, GH Pellegrin; M. Soubrier, MD, PhD, Rheumatology, CHU Gabriel Montpied; R. Belkhir, MD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud; R. Seror, MD, PhD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud; X. Mariette, MD, PhD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud; S. Pavy, MD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud. · From the Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, Le Kremlin Bicêtre; INSERM UMR-S 1136, Hôpital Pitié-Salpêtrière; Rheumatology A Department, Hôpital Cochin, University Paris Descartes; Rheumatology, Groupe Hospitalier Diaconesses Croix Saint Simon; Rheumatology Department B, Hôpital Cochin, Paris; Internal Medicine, Centre Hospitalier Universitaire (CHU) Timone, Aix Marseille Université, Marseille; Rheumatology, CHU H. Mondor, Créteil; Rheumatology, Centre hospitalier Le Mans; Rheumatology, Hôpital Salengro, Lille; Rheumatology, GH Pellegrin, Bordeaux; Rheumatology, CHU Gabriel Montpied, Clermont Ferrand, France. stephan.pavy@aphp.fr. · E. Rivière, MD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud; L. Arnaud, MD, PhD, INSERM UMR-S 1136, Hôpital Pitié-Salpêtrière; Rheumatology A Department, Hôpital Cochin, University Paris Descartes; M. Ebbo, MD, Internal Medicine, CHU Timone, Aix Marseille Université; Y. Allanore, MD, PhD, Rheumatology A Department, Hôpital Cochin, University Paris Descartes; P. Claudepierre, MD, Rheumatology, CHU H. Mondor; E. Dernis, MD, Rheumatology, Centre hospitalier Le Mans; J.M. Ziza, MD, Rheumatology, Groupe Hospitalier Diaconesses Croix Saint Simon; C. Miceli-Richard, MD, PhD, Rheumatology, Department B, Hôpital Cochin; P. Philippe, MD, Rheumatology, Hôpital Salengro; C. Richez, MD, PhD, Rheumatology, GH Pellegrin; M. Soubrier, MD, PhD, Rheumatology, CHU Gabriel Montpied; R. Belkhir, MD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud; R. Seror, MD, PhD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud; X. Mariette, MD, PhD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud; S. Pavy, MD, Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud. stephan.pavy@aphp.fr. ·J Rheumatol · Pubmed #28412700.

ABSTRACT: OBJECTIVE: Spondyloarthritis (SpA) and Takayasu arteritis (TA) are 2 chronic inflammatory diseases; their coexistence in a single patient is uncommon. The aims of our study were to describe clinical features of patients having SpA associated with TA and to identify some characteristics of the types of patients with SpA associated with TA. We also analyzed treatments used in this context. METHODS: This French multicenter retrospective survey called for observations on behalf of the Club Rhumatismes et Inflammations, with a standardized questionnaire established by the investigators. RESULTS: We included 14 patients (women: 10/14; median age at SpA diagnosis: 43.5 yrs, ranging from 19 to 63). Subtypes of SpA were ankylosing spondylitis (n = 11), psoriatic arthritis (n = 2), and synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome (n = 1). HLA-B27 was positive in 3 cases, negative in 9, and unknown in 2. SpA was diagnosed before TA in 13 cases. Imaging findings compatible with the diagnosis of TA were found with computed tomography (11/14) and/or Doppler ultrasound (10/14). Laboratory tests showed increased acute-phase reactants in all cases (C-reactive protein ≥ 25 mg/l in 71% of the cases). All patients except 1 received corticosteroids and 7 were treated with anti-tumor necrosis factor (anti-TNF). CONCLUSION: Association of SpA and TA is rare but probably not coincidental. Peripheral pulse palpation and vascular auscultation should be systematic and are the first indicators of TA in patients with SpA. Moreover, increased acute-phase reactants during SpA followup should lead to search for TA. Finally, there are therapeutic implications because anti-TNF are efficient in SpA and might be efficient in TA.

10 Article Frequency of concomitant fibromyalgia in rheumatic diseases: Monocentric study of 691 patients. 2017

Fan, Angelique / Pereira, Bruno / Tournadre, Anne / Tatar, Zuzana / Malochet-Guinamand, Sandrine / Mathieu, Sylvain / Couderc, Marion / Soubrier, Martin / Dubost, Jean-Jacques. ·Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France. · Department of Biostatistics Unit, DRCI, CHU Gabriel-Montpied, Clermont-Ferrand, France. · Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France. Electronic address: jjdubost@chu-clermontferrand.fr. ·Semin Arthritis Rheum · Pubmed #28216193.

ABSTRACT: OBJECTIVE: Fibromyalgia (FM) is a confounding factor for diagnosing and assessing rheumatic disease activity. This study sought to assess the extent of this syndrome in rheumatism patients at a French rheumatology department. METHOD: This monocentric epidemiological study enrolled all patients consulting due to rheumatoid arthritis (RA), spondyloarthritis (SpA), or connective tissue disease (CTD). FM diagnosis was confirmed or excluded according to the rheumatologist opinion and the 1990 American College of Rheumatology (ACR) criteria. RESULTS: We enrolled 691 patients, including 451 women (65.3%), with a mean age of 55.8 years (18-93). Of the enrolled patients, 325 presented with RA, 298 SpA [59 psoriatic arthritis (PsA), 137 ankylosing spondylitis (AS), 64 non-radiographic SpA (nr-SpA), and 38 peripheral SpA], and 71 CTD. The rheumatologist established FM diagnosis in 97 patients (14%), while 55 (8%) fulfilled the 1990 ACR criteria. The frequency of FM was lower in RA patients (4.9% by 1990 ACR criteria; 7.7% by expert opinion) compared to SpA (11.1% by 1990 ACR, p < 0.05; 17.5% by expert opinion, p < 0.003) and CTD (11.3% by 1990 ACR, non-significant; 28.2% by expert opinion, p < 0.001). In the SpA subgroups, FM was more common in the nr-SpA than in PsA or AS (23.9%, 9.6%, and 6.4%, by 1990 ACR, p = 0.001; 37.3%, 13.5%, and 7.2%, by expert opinion, p < 0.001). CONCLUSION: FM-like symptoms are commonly associated with rheumatic diseases. The frequency of FM is particularly high in non-radiographic axial SpA, thus raising questions about the specificity of the Assessment of SpondyloArthritis International Society (ASAS) classification criteria.

11 Article Psoriatic arthritis treated by anti-TNFs: a monocentric trial of 102 cases in Auvergne, France. 2016

Soubrier, Martin / Pereira, Bruno / Frayssac, Thomas / Abdi, Dihya / Couderc, Marion / Daron, Coline / Malochet-Guinamand, Sandrine / Mathieu, Sylvain / Tatar, Zuzana / Tournadre, Anne / Dubost, Jean-Jacques. ·Department of Rheumatology, CHU Hôpital Gabriel Montpied, Clermont-Ferrand, France. msoubrier@chu-clermontferrand.fr. · Biostatistics and Research Department (DRCI), CHU Hôpital Gabriel Montpied, Clermont-Ferrand, France. · Department of Rheumatology, CHU Hôpital Gabriel Montpied, Clermont-Ferrand, France. ·Clin Exp Rheumatol · Pubmed #27607233.

ABSTRACT: OBJECTIVES: While several registries have already evaluated the retention of anti-TNF therapy in psoriatic arthritis (PsA), they sometimes reach divergent conclusions. Our study therefore sought to assess therapeutic retention rates and predictive factors of response in a patient cohort from Auvergne, France, followed up in routine clinical practice. METHODS: Medical records of all PsA patients treated from 2002 to May 2015 were analysed. PsA diagnosis was established based on the CASPAR criteria. RESULTS: In total, 102 patients were analysed, comprising 62 men (44.6±12.6 years) and 40 women (37.8±13.4). Mean PsA evolution was 2.7 years (0.8-11.2). The most common forms were peripheral (47/102, 45.1%) and mixed (46/102, 46.1%) PsA. The anti-TNF treatment initiated was etanercept in 47 cases (45.2%), adalimumab in 29 (27.9%), infliximab in 20 (19.2%), and golimumab in six [5.8%]. In 28 cases (27.4%), anti-TNF was associated with methotrexate (MTX). Overall, the median duration of anti-TNF retention was 76.5 months. The hazard ratios (HR) for treatment cessation did not significantly differ between the etanercept and monoclonal antibody groups (HR=1.35[0.96-1.93], p=0.08). After 5 years, approximately 30.8% of etanercept patients and 68.8% of monoclonal antibody patients (adalimumab 71.2%; infliximab 67.2%) were still being treated. Combining with MTX did not prolong the overall retention rate (HR=0.85[0.37-1.96], p=0.71). Tobacco use was predictive of discontinuation (p=0.03). CONCLUSIONS: Our study demonstrates good anti-TNF treatment retention in PsA patients, as well as confirming the deleterious effect of smoking while providing no argument in favour of combined treatment with MTX to improve maintenance.

12 Article Cardiovascular events in ankylosing spondylitis: an updated meta-analysis. 2015

Mathieu, Sylvain / Pereira, Bruno / Soubrier, Martin. ·Rheumatology Department, Gabriel Montpied Teaching Hospital, 58 Rue Montalembert, Clermont-Ferrand 63003, France; GenHotel-Auvergne, EA4679, Faculty of Medicine, Clermont 1 University, Clermont-Ferrand, France. Electronic address: smathieu@chu-clermontferrand.fr. · DRCI, Gabriel Montpied Teaching Hospital, Clermont-Ferrand, France. · Rheumatology Department, Gabriel Montpied Teaching Hospital, 58 Rue Montalembert, Clermont-Ferrand 63003, France. ·Semin Arthritis Rheum · Pubmed #25455683.

ABSTRACT: OBJECTIVES: Rheumatoid arthritis is associated with increased cardiovascular risk. In the guidelines, ankylosing spondylitis (AS) is considered to have an equally high cardiovascular risk. The literature findings remain controversial. This study aims to assess the risk of myocardial infarction (MI) and stroke in AS patients. METHODS: An updated meta-analysis with a new systematic literature review using PubMed was conducted up to January 2014. Incidence of MI or stroke was calculated by metaproportion. RESULTS: In addition to the 11 previously included studies, six new studies assessed the occurrence of MI or stroke in AS patients. (1) MI. A total of 2131 MI were reported in AS patients (n = 27,532) over a mean follow-up of 15 years: incidence 5.3% (1.6%-11.0%), i.e., 0.36/100 pyrs. Seven studies revealed 17,410 MI [2.5% (95% CI: 1.8%-3.4%)] in the control group (n = 1,349,964). Meta-analysis of the seven longitudinal studies showed a significant increase in MI [OR = 1.60 (95% CI: 1.32-1.93)] in AS patients. (2) Stroke. In 11 longitudinal studies (n = 51,990), 1807 strokes were reported in AS patients over 17.6 years of follow-up: incidence 3.6% (1.5%-6.5%), i.e., 0.24/100 pyrs. Three studies reported 22,899 strokes in controls (n = 1,239,041), giving an incidence of 1.78% (1.75%-1.80%). A significant increase in stroke [OR = 1.50 (95% CI: 1.39-1.62)] in AS patients was found. CONCLUSION: AS patients appear to have a higher risk of MI and stroke. Management of cardiovascular risk factors and control of systemic inflammation should be taken into account in AS to decrease this high cardiovascular risk.

13 Article Axial calcium pyrophosphate dihydrate deposition disease revealed by recurrent sterile spondylodiscitis and epidural abscess. 2014

Grobost, Vincent / Vayssade, Marielle / Roche, Antoine / Kemeny, Jean-Louis / Soubrier, Martin. ·Rheumatology Department, Clermont-Ferrand University Hospital, CHU Gabriel-Montpied, 58, avenue Montalembert, 63003 Clermont-Ferrand, France. Electronic address: vgrobost@chu-clermontferrand.fr. · Rheumatology Department, Clermont-Ferrand University Hospital, CHU Gabriel-Montpied, 58, avenue Montalembert, 63003 Clermont-Ferrand, France. · Radiology Department, Clermont-Ferrand University Hospital, CHU Gabriel-Montpied, 58, avenue Montalembert, 63003 Clermont-Ferrand, France. · Pathology Department, Clermont-Ferrand University Hospital, CHU Gabriel-Montpied, 58, avenue Montalembert, 63003 Clermont-Ferrand, France. ·Joint Bone Spine · Pubmed #23932725.

ABSTRACT: Spondylodiscitis are frequent and clinical challenge for practionners. Axial calcium pyrophosphate dihydrate deposition disease (CPDD) is well known for cervical spine involvement with the crowned dens syndrome but other localisations are probably underdiagnosed in sterile spondylodiscitis. We report a case of recurrent sterile spondylodiscitis with epidural abscess related to CPDD proved by vertebral percutaneous needle biopsy with rapid favourable course under colchicine therapy. Axial CPDD could mimic septic spondylodiscitis with epidural abscess on MRI. Sterile spondylodiscitis are probably underdiagnosed forms of microcrystalline disease. Investigations of the presence of microcrystals should be systematically undertaken with tamponed formalin fixed biopsies. If axial CPDD is suspected, colchicine therapy could be a good therapeutic test and would avoid unnecessary antibiotic treatment.

14 Article Differences between women and men with recent-onset axial spondyloarthritis: results from a prospective multicenter French cohort. 2013

Tournadre, A / Pereira, B / Lhoste, A / Dubost, J J / Ristori, J M / Claudepierre, P / Dougados, M / Soubrier, M. ·Centre Hospitalier Universitaire Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, France. ·Arthritis Care Res (Hoboken) · Pubmed #23463610.

ABSTRACT: OBJECTIVE: To clarify sex differences in early axial spondyloarthritis (SpA). METHODS: In total, 475 patients included in the Devenir des Spondylarthropathies Indifférenciées Récentes (Outcome of Recent Undifferentiated Spondylarthropathies) cohort, a prospective multicenter French cohort of patients with early inflammatory back pain suggestive of SpA, and fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial SpA were studied. The clinical and imaging features were compared between sexes and according to the clinical or imaging arm of the ASAS criteria using univariate and multivariate analysis. RESULTS: Comparisons between the 239 men and 236 women showed that women had higher disease activity when measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Patient Global Score and higher fatigue and functional scores despite having less radiographic sacroiliitis and magnetic resonance imaging (MRI) inflammation of sacroiliac joints and the spine than men. Disease activity measured by the C-reactive protein (CRP)-based Ankylosing Spondylitis Disease Activity Score was not different between men and women. In contrast to patients classified with the clinical arm, disease activity and functional scores did not differ between women and men with sacroiliitis on imaging scans, except for fatigue and the Ankylosing Spondylitis Quality of Life questionnaire. Women with sacroiliitis had more peripheral involvement and more family history, whereas HLA-B27 positivity, elevated CRP, and MRI inflammation of the spine were associated with male sex. CONCLUSION: Women with early axial SpA according to the ASAS criteria had greater disease activity when measured by the BASDAI and worse functioning despite fewer radiologic abnormalities than men. The differences in disease expression may be confounding factors to establish the diagnosis of SpA and to assess disease activity in women, suggesting that the imaging arm is a pivotal measure in the ASAS criteria.

15 Article No significant changes in arterial stiffness in patients with ankylosing spondylitis after tumour necrosis factor alpha blockade treatment for 6 and 12 months. 2013

Mathieu, Sylvain / Pereira, Bruno / Couderc, Marion / Rabois, Emilie / Dubost, Jean-Jacques / Soubrier, Martin. ·Gabriel Montpied Teaching Hospital, Rheumatology Department, Place H. Dunant, Clermont-Ferrand, 63000, France. smathieu@chu-clermontferrand.fr ·Rheumatology (Oxford) · Pubmed #23065359.

ABSTRACT: OBJECTIVE: The increased cardiovascular risk associated with AS is attributable to multiple factors: disease activity, systemic inflammation, traditional risk factors and NSAIDs. This study aimed to investigate the effects of 24 and 52 weeks of TNF-α inhibitor treatment on arterial stiffness and cardiovascular risk factors. METHODS: Arterial stiffness was measured using the augmentation index (AIx) and pulse wave velocity (PWV), while other cardiovascular risk factors [lipid profile, blood pressure (BP) and BMI] were collected for active AS patients. RESULTS: In total, 49 patients, comprising 30 men, were included in the study, with a mean age of 46.9 (12.1) years. Of these, 20 (40.8%) patients were current smokers, while 10 were treated for hypertension. Patients had long-standing [11.9 (9.2) years] and active AS, with a high initial BASDAI [55.0 (18.2)]. Regarding treatment, 26 patients received etanercept, 17 adalimumab and 6 infliximab. No changes were observed in PWV and AIx after 6 or 12 months following TNF-α blockade [PWV 6.97 (2.03) m/s, 6.92 (1.81) m/s and 7.10 (1.95) m/s at baseline, 6 months and 1 year, respectively, P = 0.64; AIx 19.5 (13.1%), 20.2 (12.8%), 18.3 (13.5%), respectively, P = 0.87]. Lipid profiles and other cardiovascular risk factors were unchanged. However, BASDAI, BASFI and biological inflammation were significantly improved. CONCLUSION: Arterial stiffness was not improved after 6 and 12 months of anti-TNF-α therapy. However, treatment decreased biological inflammation and disease activity without causing any changes in lipid profiles and other traditional cardiovascular risk factors.

16 Article Is IL-6 an appropriate target to treat spondyloarthritis patients refractory to anti-TNF therapy? A multicentre retrospective observational study. 2012

Lekpa, Fernando Kemta / Poulain, Cécile / Wendling, Daniel / Soubrier, Martin / De Bandt, Michel / Berthelot, Jean Marie / Gaudin, Philippe / Toussirot, Eric / Goupille, Philippe / Pham, Thao / Sellam, Jérémie / Bruckert, Rémy / Paul, Muriel / Farrenq, Valérie / Claudepierre, Pascal / Anonymous3120720. ·Rheumatology Department, AP-HP, Henri Mondor University Hospital, 51 avenue du Mal de Lattre de Tassigny, 94010 Créteil, France. ·Arthritis Res Ther · Pubmed #22404969.

ABSTRACT: INTRODUCTION: The aim of this study was to evaluate, under real-life conditions, the safety and efficacy of tocilizumab in patients having failed anti-TNFα therapy for spondyloarthritis. METHODS: French rheumatologists and internal-medicine practitioners registered on the Club Rhumatismes et Inflammations website were asked to report on patients given tocilizumab (4 or 8 mg/kg) to treat active disease meeting Assessment of SpondyloArthritis International Society (ASAS) criteria for axial or peripheral spondyloarthritis, after anti-TNFα treatment failure. Safety and efficacy after 3 and 6 months were assessed retrospectively using standardised questionnaires. RESULTS: Data were obtained for 21 patients, 13 with axial spondyloarthritis (46% men; median age, 42 years; disease duration, 11 years; HLA-B27-positive, 92.3%) and eight with peripheral spondyloarthritis (25% men; median age, 40 years; disease duration, 10 years; HLA-B27-positive, 62.5%). No patients with axial disease had at least a 20 mm decrease in the BASDAI, nor a BASDAI50 response or major ASAS-endorsed disease activity score improvements after 3 or 6 months; an ASAS-endorsed disease activity score clinically important improvement was noted at month 3 in five of 13 patients and at month 6 in one of four patients. A good DAS28 response was achieved in four patients with peripheral disease, including one in EULAR remission at month 3. Four patients were still taking tocilizumab at month 6, including one in EULAR remission and one with a good DAS28 response. Tocilizumab was well tolerated, with no serious adverse events. Initially elevated acute-phase reactants declined during tocilizumab therapy. CONCLUSION: In patients having failed anti-TNFα therapy, tocilizumab decreased acute-phase reactants but failed to substantially improve axial spondyloarthritis and was inconsistently effective in peripheral spondyloarthritis.

17 Article TNF alpha antagonist therapy and safety monitoring. 2011

Pham, Thao / Bachelez, Hervé / Berthelot, Jean-Marie / Blacher, Jacques / Bouhnik, Yoram / Claudepierre, Pascal / Constantin, Arnaud / Fautrel, Bruno / Gaudin, Philippe / Goëb, Vincent / Gossec, Laure / Goupille, Philippe / Guillaume-Czitrom, Séverine / Hachulla, Eric / Huet, Isabelle / Jullien, Denis / Launay, Odile / Lemann, Marc / Maillefert, Jean-Francis / Marolleau, Jean-Pierre / Martinez, Valérie / Masson, Charles / Morel, Jacques / Mouthon, Luc / Pol, Stanislas / Puéchal, Xavier / Richette, Pascal / Saraux, Alain / Schaeverbeke, Thierry / Soubrier, Martin / Sudre, Anne / Tran, Tu-Anh / Viguier, Manuelle / Vittecoq, Olivier / Wendling, Daniel / Mariette, Xavier / Sibilia, Jean. ·Rheumatology Department, CHU Sainte-Marguerite, Marseille, France. thao.pham@mail.ap-hm.fr ·Joint Bone Spine · Pubmed #21703545.

ABSTRACT: OBJECTIVES: To develop and/or update fact sheets about TNFα antagonists treatments, in order to assist physicians in the management of patients with inflammatory joint disease. METHODS: 1. selection by a committee of rheumatology experts of the main topics of interest for which fact sheets were desirable; 2. identification and review of publications relevant to each topic; 3. development and/or update of fact sheets based on three levels of evidence: evidence-based medicine, official recommendations, and expert opinion. The experts were rheumatologists and invited specialists in other fields, and they had extensive experience with the management of chronic inflammatory diseases, such as rheumatoid. They were members of the CRI (Club Rhumatismes et Inflammation), a section of the Société Francaise de Rhumatologie. Each fact sheet was revised by several experts and the overall process was coordinated by three experts. RESULTS: Several topics of major interest were selected: contraindications of TNFα antagonists treatments, the management of adverse effects and concomitant diseases that may develop during these therapies, and the management of everyday situations such as pregnancy, surgery, and immunizations. After a review of the literature and discussions among experts, a consensus was developed about the content of the fact sheets presented here. These fact sheets focus on several points: 1. in RA and SpA, initiation and monitoring of TNFα antagonists treatments, management of patients with specific past histories, and specific clinical situations such as pregnancy; 2. diseases other than RA, such as juvenile idiopathic arthritis; 3. models of letters for informing the rheumatologist and general practitioner; 4. and patient information. CONCLUSION: These TNFα antagonists treatments fact sheets built on evidence-based medicine and expert opinion will serve as a practical tool for assisting physicians who manage patients on these therapies. They will be available continuously at www.cri-net.com and updated at appropriate intervals.

18 Article [Transversal fractures in spinal ankylosis: a case series of 17 patients]. 2011

Glace, B / Dubost, J-J / Ristori, J-M / Irthum, B / Chazal, J / Soubrier, M. ·Service de rhumatologie, CHU Gabriel-Montpied, Clermont-Ferrand, France. bglace@hotmail.fr ·Rev Med Interne · Pubmed #21146904.

ABSTRACT: PURPOSE: Transverse fractures of the spine are rare. They occur in ankylosed spine and may lead to neurological complications. We report a series of 18 cases observed in 17 patients with ankylosing spondylitis (AS). The objective of this study were to describe the clinical, diagnostic and therapeutic features of our series and to compare our results with those of the literature. METHODS: We conducted a retrospective study from 1975 to 2008 in the neurosurgery and rheumatology departments of the university hospital (CHU) of Clermont-Ferrand. RESULTS: Eighteen transverse spine fractures were documented in 17 patients (one female patient had two fractures of the lumbar vertebrae). The 13 male and four female patients included in this series had a mean age of 57.4 ± 17.2 years and AS for a mean time of 21.3 ± 12 years (5-40). All patients had spinal ankylosis with a "bamboo" spine appearance. The reasons for hospital admission were suspicion of AS flare (n=10) and suspected traumatic fracture (n=8). Trauma, in most cases minor, was noted in 15 patients. Fourteen patients presented with mechanical spinal pain and three had both mechanical and inflammatory pain. Three patients experienced severe pain on mobilization. Two patients had pyramidal syndrome. The mean time to diagnosis of the fracture was 6.8 ± 8.4 weeks (0-22). The fracture was located in cervical spine (n=2), dorsal spine (n=8) and lumbar spine (n=8). It was transdiscal and transcorporeal in nine cases each. Standard radiographs (n=18) identified the fracture in nine cases. The fracture was demonstrated in all CT-scan (n=13). Magnetic resonance imaging (MRI) (n=6) showed the fracture in five cases and epidural hematoma in one. Eleven patients had orthopedic treatment and six underwent surgery. Outcome was favorable in 16 patients. One paraplegic patient died of pulmonary embolism. CONCLUSION: Transverse fractures of the spine are rare and diagnosis should be considered in a patient with AS and ankylosed spine who presented mechanical spine pain following even minor trauma. If standard radiographs are normal, further investigations should be performed using MRI, CT-scan, or both.

19 Article [Efficacy of infliximab in the treatment of follicular occlusion triad]. 2010

Deschamps, M-E / Payet, S / Tournadre, A / Soubrier, M / Souteyrand, P / D'Incan, M. ·Service de dermatologie, Hôtel-Dieu, CHU, université Clermont-Ferrand-1, boulevard Léon-Malfreyt, 63068 Clermont-Ferrand cedex 1, France. marie.deschamps1@free.fr ·Ann Dermatol Venereol · Pubmed #20804900.

ABSTRACT: BACKGROUND: Dermatological treatments for the follicular occlusion triad have only partial and transient efficacy. PATIENTS AND METHODS: A 20-year-old patient presented folliculitis of the scalp, acne and hidradenitis suppurativa, associated with spondyloarthritis. Treatment with infliximab for rheumatologic symptoms induced complete and lasting dermatological and rheumatological remission. COMMENTS: The efficacy of anti-TNF-alpha in follicular occlusion triad provided confirmation that infection is not at the heart of the aetiological process. However, efficacy data is still sparse and additional studies are required.

20 Article TNFα antagonist therapy does not increase the Epstein-Barr virus burden in patients with rheumatoid arthritis or ankylosing spondylitis. 2010

Couderc, Marion / Payet, Sarah / Henquell, Cécile / Dubost, Jean-Jacques / Soubrier, Martin. ·Service de rhumatologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France. mcouderc@chu-clermontferrand.fr ·Joint Bone Spine · Pubmed #20542718.

ABSTRACT: OBJECTIVE: The risk of non-Hodgkin lymphoma is increased in rheumatoid arthritis (RA) but not in ankylosing spondylitis (AS). In RA, the degree of inflammation is closely associated with the lymphoma risk. Whether immunosuppressants such as methotrexate and TNFα antagonists affect the lymphoma risk in RA is unclear. The Epstein-Barr virus (EBV) may contribute to the pathogenesis of RA and may be involved in the development of lymphoma in patients taking methotrexate and/or TNFα antagonists, although these points remain debated. EBV load monitoring during immunosuppressive treatment may predict the occurrence of EBV-related lymphoma. Here, our objective was to prospectively measure the EBV load in patients receiving TNFα antagonists for RA or AS. METHODS: We prospectively studied patients with RA or AS before and after TNFα antagonist therapy initiation. The EBV load was measured in blood samples using the EBV R-gene Quantification Kit. Disease activity at the time of blood sampling was evaluated by determining the Disease Activity Score 28 (DAS28) in RA patients and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in AS patients. RESULTS: We included 46 patients with RA (82.6% women; mean age, 52.7 ± 11.3 years) and 27 with AS (men, 81.5%; mean age, 45.1 ± 12.7 years). In the RA group, the EBV load was measured at baseline and 9.72 ± 5.7 months later. The baseline EBV load was undetectable in 33 (70.2%) patients; mean EBV load in the 13 remaining patients was 9389 copies/ml (3.47 log₁₀ ± 0.45). Baseline EBV load did not correlate with disease activity (DAS28). At the follow-up assay, the EBV load became positive in five patients and increased significantly in one patient (four patients on etanercept, one on adalimumab, and one on infliximab); it became negative in six patients (five on adalimumab and one on etanercept) and showed non-significant changes in six patients. Mean EBV load in patients positive at follow-up was 3.63 ± 0.52 log₁₀ copies/ml. Mean DAS28 was 4.78 ± 1.1 at baseline and 2.94 ± 1.24 at follow-up. At follow-up, a good EULAR response was noted in 33 (71.7%) patients and a moderate EULAR response in seven (15.2%) patients. In the AS group, the baseline EBV load measurement occurred after 12.9 ± 10.6 months. Baseline EBV load was undetectable in 25 (92.6%) patients; mean load in the remaining two patients was 4.15 ± 0.46 log₁₀ copies/ml. At follow-up, the EBV load became positive in two patients (one on adalimumab and one on infliximab) and became negative in one patient (on adalimumab). Mean load in positive patients was 3.33 ± 0.24 log₁₀ copies/ml. Mean BASDAI was 55.1 ± 16.2 at baseline and 17.88 ± 18.62 at follow-up. A positive EBV load was significantly more common in the RA group than in the AS group (P = 0.039). EBV load changes did not differ significantly between the RA and AS groups or across TNFα antagonists. No cases of lymphoma were recorded. CONCLUSION: Introducing TNFα antagonist therapy does not affect the EBV load in patients with RA or AS. EBV load monitoring is probably unnecessary in patients given TNFα antagonists for RA or AS.

21 Article Effects of 14 weeks of TNF alpha blockade treatment on lipid profile in ankylosing spondylitis. 2010

Mathieu, Sylvain / Dubost, Jean-Jacques / Tournadre, Anne / Malochet-Guinamand, Sandrine / Ristori, Jean-Michel / Soubrier, Martin. ·Rheumatology department, G.-Montpied Hospital, 58, rue Montalembert, 63003 Clermont-Ferrand, France. smathieu@chu-clermontferrand.fr ·Joint Bone Spine · Pubmed #20022785.

ABSTRACT: OBJECTIVE: Cardiovascular morbidity and mortality seem to be increased in ankylosing spondylitis, perhaps as the result of biological inflammation and consecutive dyslipidemia. This study aims to investigate the impact of TNF alpha-inhibitors, an effective treatment, on lipid profile. METHODS: Thirty-four ankylosing spondylitis (AS) patients with active disease undergoing anti-TNF alpha therapy (n=20, infliximab; n=7, etanercept; n=7, adalimumab) were recruited. Disease activity parameters, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were assessed at baseline and after 14 weeks of treatment. RESULTS: After 14 weeks of TNF alpha blockade treatment, there was a significant increase in levels of total cholesterol (5.08+/-1.20 vs. 4.73+/-1.12 mmol/l; p=0.01) and HDL-cholesterol (1.61+/-0.47 vs. 1.47+/-0.35 mmol/l; p=0.008), but no resulting change in the atherogenic index (3.43+/-1.13 vs. 3.35+/-0.93; p=0.87). There was also no change in concentrations of triglycerides (1.33+/-1.22 vs. 1.27+/-0.98 mmol/l; p=0.794) and LDL-cholesterol (3.15+/-0.99 vs. 2.91+/-0.93 mmol/l; p=0.24). TNF alpha inhibitor treatment was followed by a significant improvement in all disease activity parameters: VAS pain or VAS disease activity, BASDAI or BASFI and systemic inflammation. Sub-group analysis showed that monoclonal antibodies increased total and LDL-cholesterol levels but did not change the atherogenic index. Conversely, 14 weeks of etanercept treatment was followed by no change in lipid profile. CONCLUSION: TNF alpha inhibitors may be successful in reducing cardiovascular risk in AS, as in RA, but not by affecting lipid profile. However, there is insufficient documented evidence, and long-term investigations are needed to define the possible protective mechanisms of TNFalpha inhibitor treatment in spondylarthropathies.

22 Minor Serum procalcitonin measurement is not a useful biomarker in the detection of primary infectious spondylodiscitis. 2017

Dubost, Jean-Jacques / Lopez, Julien / Pereira, Bruno / Couderc, Marion / Tournadre, Anne / Soubrier, Martin. ·Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France. Electronic address: jjdubost@chu-clermontferrand.fr. · Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France. · Biostatistic Unit, DRCI, CHU Gabriel-Montpied, Clermont-Ferrand, France. ·Joint Bone Spine · Pubmed #27659402.

ABSTRACT: -- No abstract --

23 Minor Active plantar fibromatosis occurring under anti-TNFα therapy for spondyloarthritis. 2017

Couderc, Marion / Kemeny, Jean-Louis / Lhoste, Agnès / Soubrier, Martin / Dubost, Jean-Jacques. ·Rheumatology Department, Clermont-Ferrand Teaching Hospital, place Henri-Dunant, 63000 Clermont-Ferrand, France. Electronic address: mcouderc@chu-clermontferrand.fr. · Anatomopathology laboratory, Clermont-Ferrand Teaching Hospital, place Henri-Dunant, 63000 Clermont-Ferrand, France. · Radiology Department, Clermont-Ferrand Teaching Hospital, place Henri-Dunant, 63000 Clermont-Ferrand, France. · Rheumatology Department, Clermont-Ferrand Teaching Hospital, place Henri-Dunant, 63000 Clermont-Ferrand, France. ·Joint Bone Spine · Pubmed #27324608.

ABSTRACT: -- No abstract --

24 Minor Mixed effect of tocilizumab in spondylarthritis. Comments about the article by Wendling et al. entitled "Short-term effect of IL-6 inhibition in spondylarthritis". Joint Bone Spine 2010;77:624-5. 2012

Malochet-Guinamand, Sandrine / Soubrier, Martin. · ·Joint Bone Spine · Pubmed #22041094.

ABSTRACT: -- No abstract --

25 Minor Alveolar hemorrhage after infliximab therapy. 2010

Jeannin, Gaelle / Mathieu, Sylvain / Kemeny, Jean-Louis / Caillaud, Denis / Soubrier, Martin. · ·Joint Bone Spine · Pubmed #20171918.

ABSTRACT: -- No abstract --