Publications by authors named "Alain Saraux"

Objective: To describe the health care use of patients with symptomatic knee or hip OA and to identify factors associated with health care use trajectories over a 10-year period.

Methods: This study used longitudinal data from the multicentre "Knee-and-Hip-OsteoArthritis-Long-term-Assessment" cohort, which comprised 878 patients with OA diagnoses confirmed by both a physician and radiographic evidence. We identified homogeneous subgroups of trajectories based on individual health care consumption over time via latent class growth analysis.

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Medicine is not part of the fine arts. However, it is the art, scientifically informed, of care. Rheumatology in particular requires the ability to observe, listen, feel and interpret with humanity to care for people with musculoskeletal diseases.

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Objective: To assess the prevalence of giant cell arteritis (GCA) or cancer detected via 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) in patients with polymyalgia rheumatica (PMR) without clinical signs suggestive of GCA.

Method: This monocentric retrospective cohort study analyzed PET-CT scans performed for clinical suspicion of PMR since 2018. Patients meeting the 2012 ACR/EULAR criteria for PMR without clinical indications of GCA or cancer were included.

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Nomenclature for the disease widely known as Sjögren syndrome has proven unsatisfactory. Patients have perceived 'syndrome' as indicative of a vague collection of symptoms, prompting the Sjögren's Foundation to abandon the term. Furthermore, the traditional distinction between 'primary' and 'secondary' forms fails to account for the complex interplay between overlapping autoimmune diseases.

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Objective: This systematic literature review provides a comprehensive overview of the use of machine learning (ML) in hand imaging of rheumatic musculoskeletal diseases (RMDs). The review evaluates ML algorithms, imaging modalities, patient populations, validation methods, and areas for improvement.

Methods: The review was conducted following PRISMA guidelines and registered with PROSPERO.

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Objective: The SEMAPHORE trial evaluated the efficacy and safety of tocilizumab (TCZ) treatment in patients with glucocorticoid (GC)-dependent polymyalgia rheumatica (PMR). TCZ reduced GC dose and disease activity at week 24. This study aimed to assess relapse rates after stopping TCZ treatment in patients achieving remission at week 24.

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Objectives: To investigate the occurrence of spinal degenerative lesions (DL)s in axial spondyloarthritis (axSpA) inception cohort in radiographs and MRI over 10 years (10Y), to assess their changes over time and factors associated with them.

Methods: Whole spine MRI and cervical and lumbar spine radiographs at baseline/5Y/10Y of patients with axSpA from the DESIR cohort were assessed for DLs by three readers. For descriptive analyses, DLs were defined by agreement between ≥ 2/3 readers or using the average of their assessments, at the patient level (≥ 1 lesion/patient).

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Objectives: To compare two strategies-a hydrocortisone replacement strategy and a prednisone tapering strategy-for their success in glucocorticoid discontinuation in patients with rheumatoid arthritis (RA) with low disease activity (LDA).

Methods: The Strategies for glucocorticoid TApering in Rheumatoid arthritis (STAR) study was a double- blind, double-placebo randomised controlled trial including patients with RA receiving a stable dose of glucocorticoid 5 mg/day for ≥3 months and were in LDA for ≥3 months. Patients were randomly assigned in a 1:1 ratio to either replace prednisone with 20 mg/day of hydrocortisone for 3 months, then reduce to 10 mg/day for 3 months before discontinuation or to taper prednisone by 1 mg/day every month until complete discontinuation, contingent on maintaining LDA.

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Background: Moderate doses of glucocorticoids result in improvements in nearly all patients with polymyalgia rheumatica, but related adverse events are common in older individuals. We aimed to evaluate whether treatment with baricitinib (a Janus kinase 1/2 inhibitor) results in disease control without the use of oral glucocorticoids in people with recent-onset polymyalgia rheumatica.

Methods: We conducted a randomised, double-blind, placebo-controlled, parallel-group trial at six expert centres in France.

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Introduction: Celiac disease (CD) affects the small intestine, leading to a progressive disappearance of intestinal villi, and can be found in association with several other autoimmune and inflammatory conditions. The main objective of this study was to determine the prevalence and the clinical significance of anti-transglutaminase and anti-endomysium antibodies in patients diagnosed with early rheumatoid arthritis (RA) and spondyloarthritis (SpA).

Methods: We measured anti-transglutaminase and anti-endomysium antibodies in biobanked serum samples at inclusion in two French prospective multicenter cohorts of patients with suspected early rheumatoid arthritis (ESPOIR, n = 713) and spondyloarthritis (DESIR, n = 709).

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Objectives: Salivary gland ultrasound (SGUS) has an interest in primary Sjögren's disease (pSD) for diagnosis, but the evolution of parenchymal lesions over time is unknown. The objective of this study was to assess the severity of ultrasound abnormalities in relation to pSD duration from the time of buccal dryness onset.

Methods: In this cross-sectional international multicentre study, patients with pSD according to the 2002 or 2016 ACR/EULAR classification criteria were included.

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Objectives: The objectives of this study were to evaluate the effectiveness of short message service (SMS) and/or email reminders in improving influenza vaccination coverage rates among RA patients treated with anti-TNF therapies, and to identify factors associated with vaccination.

Methods: This study was a nested randomized controlled trial in the ART e-cohort, an ongoing French nationwide multicentre prospective cohort of RA patients treated with anti-TNF therapy. Patients were 1:1 randomized, with stratification on age.

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Article Synopsis
  • A sedentary lifestyle, influenced by factors like screen addiction, poses significant public health risks, prompting this study to explore the effects of reducing smartphone use on physical activity levels.
  • The research involved 490 participants in a challenge to cut smartphone use by one hour daily for a week, with data collected through online questionnaires before and after the challenge.
  • Results showed that 25.7% of participants succeeded in reducing their screen time, with 89% of them also increasing their physical activity, suggesting that limiting smartphone use can effectively promote healthier activity levels.
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Article Synopsis
  • The French Society of Rheumatology updated its recommendations for managing rheumatoid arthritis (RA) based on the latest EULAR guidelines, involving a wide range of experts and patient representatives.
  • The guidelines stress the importance of shared decision-making and comprehensive management for individuals with RA or those at risk, focusing on both drug and non-drug therapies.
  • Additional emphasis is on the diagnosis and treatment of RA-related interstitial lung disease (RA-ILD), highlighting the need for collaboration between rheumatologists and pulmonologists for effective management.
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Reading hand and foot X-rays in rheumatoid arthritis patients is difficult and time-consuming. In research, physicians use the modified Sharp van der Heijde Sharp (mvdH) score by reading of hand and foot radiographs. The aim of this study was to create a new method of determining the mvdH via eye tracking and to study its concordance with the mvdH score.

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Article Synopsis
  • A web-based ecological momentary assessment (EMA) tool was developed to monitor symptoms in patients with Sjögren's disease (SjD), focusing on daily variability in symptoms over three months.
  • The study involved 45 participants, primarily women, who recorded their symptoms through the WebApp, allowing comparisons with traditional paper questionnaires.
  • Results showed a high level of user satisfaction (SUS score of 90) and effective symptom tracking, confirming the tool's usefulness for accurately capturing daily experiences of SjD patients.
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Background: Physical activity has been shown to reduce obstetrical risks however pregnant women reduce their physical activity and sedentary behaviors increase.

Objective: Our aim was to evaluate the impact of a smartphone application developed to increase daily physical activity in pregnant women.

Methods: We enrolled 250 pregnant women in a prospective randomized controlled study.

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Background: Inception cohorts aim to describe chronic diseases from diagnosis and over years of follow-up. Axial spondyloarthritis (axSpA) diagnosis might be challenging during the first years of the disease. Thus, identifying the features that will be associated with a confirmed diagnosis over time is key.

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Objective: To assess whether using ultrasound (US) in addition to clinical information versus only clinical information in a treat-to-target (T2T) strategy leads to more clinical remission and to less radiographic progression in RA.

Methods: Patients with RA from the 2-year prospective BIODAM cohort were included. Clinical and US data (US7-score) were collected every 3 months and hands and feet radiographs every 6 months.

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Objective: To develop recommendations for the routine management of patients with polymyalgia rheumatica (PMR).

Methods: Following standard procedures, a systematic review of the literature by five supervised junior rheumatologists, based on the questions selected by the steering committee (5 senior rheumatologists), was used as the basis for working meetings, followed by a one-day plenary meeting with the working group (15 members), leading to the development of the wording and determination of the strength of the recommendations and the level of agreement of the experts.

Results: Five general principles and 19 recommendations were drawn up.

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Introduction: Hypophosphatasia (HPP) is a rare genetic disease caused by loss-of-function mutations in the ALPL gene encoding the tissue non-specific alkaline phosphatase (ALP). Mild HPP is usually misdiagnosed in adult age. While an elevated serum ALP value draws more attention than a low value, low serum ALP should be better recognised and may lead to HPP detection.

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