Publications by authors named "Stephane Ederhy"

Background And Aims: Immune checkpoint inhibitors (ICI) are associated with life-threatening myocarditis but milder presentations are increasingly recognized. The same autoimmune process that causes ICI myocarditis can manifest concurrent generalized myositis, myasthenia-like syndrome, and respiratory muscle failure. Prognostic factors for this 'cardiomyotoxicity' are lacking.

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Cancer-treatment induced cardiovascular diseases are a concern in early breast cancer, especially when radiation is involved and systemic treatments may contribute. Our primary objective was to estimate the frequency of cardiac adverse events after early breast cancer treatment. We performed a systematic review on cardiac events after early breast cancer treatment, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, by searching PubMed, Scopus and Web of Science and cross-checking references from international guidelines on breast cancer treatment and cardio-oncology.

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Background: Immune checkpoint inhibitors (ICIs) have transformed cancer treatment, but ICI myocarditis (ICI-M) remains a potentially fatal complication. The clinical implications and predictors of left ventricular ejection fraction (LVEF) <50% in ICI-M are not well understood.

Objectives: The aim of this study was to identify factors associated with LVEF <50% vs ≥50% at the time of hospitalization for ICI-M.

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Background: Immune checkpoint inhibitors (ICIs) may induce overlapping myositis/myasthenia gravis (MG) features, sparking current debate about pathophysiology and management of this emerging disease entity. We aimed to clarify whether ICI-induced (ir-) myositis and ir-MG represent distinct diseases or exist concurrently.

Methods: We performed a retrospective multicenter cohort study.

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Background: Immune checkpoint inhibitor (ICI)-induced myocarditis is a life-threatening adverse drug reaction. Abatacept (a CTLA-4-immunoglobulin fusion protein) has been proposed as a compassionate-use treatment for ICI myocarditis (in combination with corticosteroids and ruxolitinib) but no clinical trial has yet been performed. The abatacept dose can be adjusted using real-time assessment of its target, the CD86 receptor occupancy on circulating monocytes (CD86RO).

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Article Synopsis
  • - Acalabrutinib, a more advanced treatment for chronic lymphocytic leukemia, has a better safety profile than older drugs but lacks clear guidelines on managing its side effects, prompting a study to establish best practices.
  • - A team of medical professionals across France found that hospital pharmacists should evaluate drug interactions before starting patients on acalabrutinib and advised against using it with certain medications that can increase risks of toxicity or reduce effectiveness.
  • - The study highlighted the need for monitoring blood pressure during treatment, outlined protocols for managing procedures, and suggested headache management strategies, demonstrating the importance of teamwork in improving patient care while using acalabrutinib.
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Article Synopsis
  • Immune-checkpoint inhibitors (ICIs) can lead to serious heart issues like myocarditis, which can also involve broader muscle-related symptoms, highlighting the need for understanding associated risks.
  • A study conducted across 17 countries from 2014 to 2023 examined data from 748 patients to identify factors that predict severe outcomes related to these heart complications, using a statistical model for analysis.
  • Key findings indicated that certain conditions (like active thymoma) and symptoms (like low heart function) significantly increased the risk of severe heart-related events, and a risk score created from these factors effectively predicted outcomes, validated in multiple cohorts.
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Background: Left atrial (LA) strain is a simple marker of LA function. The aim of the study was to evaluate the determinants of atrial cardiomyopathy in AF.

Methods: In this pilot study, we prospectively evaluated clinical, biological, metabolomic and echocardiographic parameters for 85 consecutive patients hospitalized for atrial fibrillation (AF) with restoration of sinus rhythm at 6 months.

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Article Synopsis
  • * Research shows that patients with thymic epithelial tumors (TET), especially thymoma, experience ICI-related myotoxicities more frequently and with greater severity than those with other cancers.
  • * The presence of anti-acetylcholine-receptor antibodies suggests a link between thymic-related autoimmune responses and ICI myotoxicities, indicating that assessing the thymus could help predict these serious side effects in patients undergoing ICI therapy.
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Background: Acute myocardial infarction (AMI) is one of the major cardiac complications in patients hospitalized in the intensive care unit (ICU) for non-cardiac disease. A better knowledge of ischemic and bleeding risks in these patients is needed to identify those most likely to benefit from specific cardiac management. We therefore assessed the incidence and predictors of a composite outcome of severe ischemic event (AMI recurrence, ischemic stroke), major bleeding, or all-cause death in this setting.

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Post-transplant cyclophosphamide (PT-Cy) is effective for graft-versus-host disease (GVHD) prophylaxis, but it may cause dose-dependent toxicities, particularly in frail patients. Therefore, we compared the outcomes with a reduced PT-Cy total dose (70 mg/kg) to those with the standard PT-Cy dose (100 mg/kg) in haploidentical hematopoietic cell transplantation (HCT) patients aged ≥ 65 years and those with cardiac comorbidities. All consecutive patients with a hematological malignancy receiving peripheral blood stem cells (PBSCs) after a thiotepa-based conditioning with low-dose antithymocyte globulin were included.

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Article Synopsis
  • The study examines the prevalence and predictors of cerebral lesions in patients with immune thrombotic thrombocytopenic purpura (iTTP) and hemolytic uremic syndrome (HUS) during their acute phases.
  • One-third of the 73 patients analyzed showed acute ischemic lesions on MRI, and neurological symptoms were not significantly different between iTTP and HUS cases.
  • Key factors predicting these lesions included the presence of old infarcts, elevated blood pulse pressure, and a diagnosis of iTTP, indicating potential areas for enhanced treatment approaches.*
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Background: Immune checkpoint inhibitors (ICIs) are approved for multiple cancers but can result in ICI-associated myocarditis, an infrequent but life-threatening condition. Elevations in cardiac biomarkers, specifically troponin-I (cTnI), troponin-T (cTnT), and creatine kinase (CK), are used for diagnosis. However, the association between temporal elevations of these biomarkers with disease trajectory and outcomes has not been established.

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Background: Immune checkpoint inhibitors (ICI) have transformed cancer treatment over the last decade. Alongside this therapeutic improvement, a new variety of side effects has emerged, called immune-related adverse events (irAEs), potentially affecting any organ. Among these irAEs, myocarditis is rare but life-threatening.

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Article Synopsis
  • The study investigates the connection between immune-checkpoint inhibitor (ICI)-associated myotoxicity, specifically looking at myocarditis and myositis, which can be life-threatening.
  • It details a treatment strategy that involved the use of mechanical ventilation for respiratory muscle issues and the administration of the drugs abatacept and ruxolitinib in patients diagnosed with severe ICI myocarditis.
  • Results showed a significant drop in myotoxicity-related fatalities from 60% in the initial patient group to just 3.4% in the later group, indicating the effectiveness of early intervention and specific treatment adjustments.
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