Publications by authors named "Stephane Nancey"

Background And Aims: Pneumococcal vaccination is essential for patients with inflammatory bowel diseases (IBD), but its efficacy is reduced in those on antitumor necrosis factor (TNF) or immunosuppressive therapy. This study compared immune responses to standard versus intensified pneumococcal vaccination strategies in IBD patients receiving anti-TNF (±immunosuppressors) or vedolizumab.

Methods: In a prospective, multicenter, randomized open-label study across 7 French university hospitals, IBD patients in clinical remission on biologic therapy (anti-TNF ± immunosuppressors, or vedolizumab) were randomized 1:1 to an intensified (PCV13/PCV13/PPSV23) or standard (PCV13/PPSV23) regimen.

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Background & Aims: Tofacitinib and upadacitinib are Janus kinase (JAK) inhibitors that are increasingly used for the treatment of acute severe ulcerative colitis (ASUC). However, comparative analyses of safety and effectiveness have not been performed for their use in this setting.

Methods: This multicenter, retrospective study enrolled hospitalized adult patients treated with tofacitinib or upadacitinib for ASUC between January 2019 and June 2024.

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Inflammatory bowel diseases (IBDs) are chronic inflammatory conditions of the gastrointestinal tract that are multifactorial in nature. The pathophysiology involves interactions between the host immune system and environmental factors, including the gut microbiota, in genetically predisposed individuals. Advances in understanding these interactions have led to the development of novel therapeutic targets, ranging from anti-TNFα to more recent anti-interleukin 23 treatments.

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Torque teno virus (TTV) DNA load in plasma is suggested as a marker for immunosuppression post-transplantation. Crohn's disease (CD) arises from genetic susceptibility, environmental factors, and dysbiosis, causing immune responses. This study examines TTV DNA load in CD patients in remission and its correlation with relapse.

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Background & Aims: JAK inhibitor-associated acne is a common but poorly understood adverse event. This study aimed to investigate the epidemiology, clinical characteristics, and treatment outcomes of this condition in patients with inflammatory bowel disease (IBD).

Methods: This international, multicenter, retrospective cohort study consecutively enrolled JAK-inhibitor-treated patients with IBD who subsequently developed acne.

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Background And Aims: Anti-tumor necrosis factor-α inhibitors (anti-TNFs) are the established treatment for perianal Crohn's disease (pCD), but relapse and non-response are common. Data on second- and third-line biologics are limited. We present the first direct comparison of second- and third-line biologics in pCD patients with active perianal disease previously treated with first-line anti-TNFs.

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Background: While three Janus kinase inhibitors (JAKi) have demonstrated efficacy in ulcerative colitis (UC), scarce data exist regarding JAKi intraclass switching.

Aim: To evaluate the effectiveness and safety of a second JAK inhibitor in UC.

Methods: This was a multicentre, retrospective, observational cohort including patients with moderate to severe UC who received a second-line of JAKi after failure or intolerance of a first.

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Background And Aims: Real-life data regarding inflammatory bowel disease (IBD) evolution after switch from intravenous infliximab (IV-IFX) to subcutaneous infliximab (SC-IFX) is necessary. The aim of this prospective multicenter cohort study was to describe the persistence, effectiveness and tolerance of SC-IFX after switch from IV-IFX.

Methods: IBD patients in steroid-free clinical remission for at least 6 months on IV-IFX were enrolled in a prospective national French cohort when they switched to SC-IFX.

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Background: Real-world effectiveness and safety of upadacitinib in patients with Crohn's disease (CD) remain unclear.

Aims: This study aimed to evaluate the effectiveness and safety of upadacitinib in a real-world cohort.

Methods: From September 2022 to June 2024, all consecutive patients with refractory luminal CD treated with once daily upadacitinib 45 mg in 29 French GETAID centres were retrospectively included.

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Article Synopsis
  • The study addresses how Inflammatory Bowel Disease (IBD) affects the sexual quality of life in young patients.
  • A new score called BLOOMI was developed and validated for assessing sexual QoL in youth aged 15-25, based on established measures like IIEF and SFQ28.
  • Results showed BLOOMI correlates strongly with other validated scores, revealing significant issues like erectile dysfunction and low scores in sexual desire and arousal, alongside factors like fatigue impacting QoL.
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Background: Multiple studies have evaluated fecal microbiota transfer (FMT) in patients with ulcerative colitis (UC) using single-donor (SDN) and multidonor (MDN) products. Systematic review and meta-analysis were performed to compare the safety of SDN and MDN products.

Methods: Systematic searches were performed in Web of Science, Scopus, PubMed, and Orbit Intelligence to identify studies that compared FMT products manufactured using SDN or MDN strategies against control treatment in patients with UC.

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Background & Aims: Breast cancer is the most common malignancy observed in patients with inflammatory bowel diseases (IBD). The aim of our study was to evaluate incident cancer rate (recurrence or new-onset cancer) in a cohort of patients with IBD with a history of breast cancer according to the subsequent IBD treatment provided.

Methods: A multicenter retrospective study included consecutive patients with IBD with prior breast cancer.

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Background And Aims: Achieving deep remission, encompassing clinical, endoscopic, and biological remission, is the goal in managing Crohn's disease (CD). The role of histological remission (HR) remains unclear. This study aimed to examine the impact of histological inflammation on clinical relapse risk in CD and explore the relationship between histology, endoscopic scores, and biomarkers.

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Background: ReFLECT was a French, prospective, multicenter, observational cohort study evaluating the effectiveness and safety of the infliximab (IFX) biosimilar CT-P13 in a real-world setting. Here, we describe the results for adults with inflammatory bowel disease (IBD).

Methods: Eligible patients with IBD were recruited and received intravenous CT-P13 induction and/or maintenance therapy; patients were either naive to IFX (IFX-naive) or previously treated with IFX originator or another IFX biosimilar (IFX-switched).

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Objectives: Elderly hospitalized patients with inflammatory bowel disease (IBD) flare and concurrent Clostridioides difficile infection (CDI) are considered at high risk of IBD-related complications. We aimed to evaluate the short-,intermediate-, and long-term post-discharge complications among these patients.

Methods: A retrospective multicenter cohort study assessing outcomes of elderly individuals (≥60 years) hospitalized for an IBD flare who were tested for CDI (either positive or negative) and discharged.

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Article Synopsis
  • Therapeutic Drug Monitoring (TDM) is crucial for managing inflammatory bowel disease (IBD) patients on infliximab (IFX) or adalimumab, especially when there's a loss of response to these treatments; however, TDM isn't recommended for other biologic therapies.
  • A review of literature indicates that TDM might be beneficial for IFX subcutaneous (SC) use, while it's not effective for golimumab, and findings on vedolizumab are inconsistent; ustekinumab shows some promise, but less so than anti-TNF agents.
  • Recent advancements suggest that using dashboard systems for precision dosing of anti-TNF agents could optimize treatment, emphasizing a proactive approach to TDM.
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  • * In total, 36 patients were treated with a single local injection, and results showed that 47.2% achieved clinical remission at 24 weeks, while 41.6% achieved combined remission.
  • * These findings suggest that approximately half of the patients had a successful response to darvadstrocel therapy in a real-world setting, indicating its potential effectiveness for treating this condition.
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  • Biosimilars like CT-P17 offer cost-effective treatment options for patients with inflammatory bowel diseases (IBD) and chronic inflammatory rheumatic diseases (CIRD), but patient beliefs about these treatments can impact their adherence to switching.
  • This study involved 232 adult patients who transitioned to CT-P17 from either a low-concentration biosimilar or the reference adalimumab to gauge their treatment satisfaction and experiences over three months.
  • Results showed that satisfaction remained stable overall, but significantly more patients switching from a low-concentration biosimilar reported increased satisfaction compared to those switching from the reference product.
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  • A study was conducted with 941 IBD patients to assess their satisfaction with different adalimumab preparations, including biosimilars and the original brand, Humira.
  • The average satisfaction rating was 8.5 out of 10, with the highest satisfaction observed for Humira and its biosimilars like Hulio and Amgevita, where scores were notably above 8.5.
  • Injection site reactions were reported by 31.8% of patients, and a portion of those previously treated with another adalimumab had discontinued due to side effects; overall, patient satisfaction remained high despite these issues.
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  • The study aimed to evaluate how well two university hospitals followed French guidelines to prevent infections related to central venous catheters (CVCs).
  • An observational audit was carried out in 7 wards using a digital tool to gather data on compliance.
  • Results indicated that while hand hygiene practices were generally good (90% compliance), there were notable gaps in glove use and rinsing practices; further investigation is needed to understand the barriers to following these evidence-based recommendations.
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: Corticosteroids used to induce a response in Crohn's disease (CD) and ulcerative colitis (UC) may cause adverse reactions. The DICE study aimed to quantify and investigate factors associated with their use. : This cross-sectional, non-interventional study conducted in seven countries allowed us to collect data on oral corticosteroid exposure and excessive use (cf.

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Background & Aims: The aim of this study was to assess the long-term effectiveness and safety of risankizumab maintenance treatment in a large real-world cohort of patients with Crohn's Disease (CD).

Methods: From May 2021 to August 2023, all consecutive patients with CD treated with risankizumab in 25 GETAID centers have been retrospectively included. The primary endpoint was steroid-free clinical remission (Harvey Bradshaw Index [HBI] <5) at 52 weeks.

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Crohn disease (CD) is an inflammatory bowel disease whose pathogenesis involves inappropriate immune responses toward gut microbiota on genetically predisposed backgrounds. Notably, CD is associated with single-nucleotide polymorphisms affecting several genes involved in macroautophagy/autophagy, the catabolic process that ensures the degradation and recycling of cytosolic components and microorganisms. In a clinical translation perspective, monitoring the autophagic activity of CD patients will require some knowledge on the intrinsic functional status of autophagy.

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Conventional therapies for inflammatory bowel diseases are mainly based on systemic treatments which cause side effects and toxicity over long-term administration. Nanoparticles appear as a valid alternative to allow a preferential accumulation in inflamed tissues following oral administration while reducing systemic drug exposure. To increase their residence time in the inflamed intestine, the nanoparticles are here associated with a hydrogel matrix.

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