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Arthritis in primary Sjögren's syndrome: Characteristics, outcome and treatment from French multicenter retrospective study

Identifieur interne : 000020 ( Hal/Checkpoint ); précédent : 000019; suivant : 000021

Arthritis in primary Sjögren's syndrome: Characteristics, outcome and treatment from French multicenter retrospective study

Auteurs : Adrien Mirouse [France] ; Raphaele Séror [France] ; Eric Vicaut [France] ; Xavier Mariette [France] ; Maxime Dougados [France] ; Anne-Laure Fauchais [France] ; Alban Deroux [France] ; Azeddine Dellal [France] ; Nathalie Costedoat-Chalumeau [France] ; Guillaume Denis [France] ; Jeremie Sellam [France] ; Jean-Benoît Arlet [France] ; Christian Lavigne [France] ; Geoffrey Urbanski [France] ; Dominique Fischer-Dumont [France] ; Abdou Diallo [France] ; Olivier Fain [France] ; Arsène Mékinian [France]

Source :

RBID : Hal:hal-02171337

English descriptors

Abstract

OBJECTIVE: To describe the characteristics and the outcome of primary Sjögren Syndrome (pSS) associated arthritis and to compare the efficacy of different therapeutic regimen.METHODS: We conducted a retrospective study using Club Rhumatisme and Inflammation (CRI) and French Internal Medicine Society (SNFMI) networks. All patients with a diagnosis of pSS and at least one episode of clinical and/or echographic synovitis were included. Patients with synovitis (cases) were compared to pSS patients without synovitis (controls).RESULTS: 57 patients (93% women) were included with a median age of 54 years [45-63]. Patients with synovitis had more frequently lymph node enlargement (12.3% vs. 1.8%, p = .007) and a higher ESSDAI score (8 [6-12] vs. 2 [1-4], p < .0001). There was no difference concerning CRP levels, rheumatoid factor and cyclic citrullinated peptide (CCP)-antibodies positivity. Among 57 patients with synovitis, 101 various treatment courses have been used during the follow-up of 40 [22.5-77] months. First treatment course consisted in steroids alone (3.5%), steroids in association (79%) with hydroxychloroquine (HCQ) (49%), methotrexate (MTX) (35%), rituximab (RTX) (5.3%) or other immunosuppressive drugs (7%). HCQ, MTX, and RTX were associated with a significant reduction of tender and swollen joint count, and a significant steroids-sparing effect. No difference could be shown for the joint response between these treatment regimens.CONCLUSION: pSS articular manifestations may include synovitis which could mimic rheumatoid arthritis but differ by the absence of structural damage. Even if the use of HCQ, MTX, and RTX seem to be effective for joint involvement, the best regimen remains to be determined.


Url:
DOI: 10.1016/j.autrev.2018.06.015

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<country>France</country>
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<author>
<name sortKey="Fain, Olivier" sort="Fain, Olivier" uniqKey="Fain O" first="Olivier" last="Fain">Olivier Fain</name>
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<hal:affiliation type="institution" xml:id="struct-413221" status="VALID">
<orgName>Sorbonne Université</orgName>
<orgName type="acronym">SU</orgName>
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<address>
<addrLine>21 rue de l’École de médecine - 75006 Paris</addrLine>
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</address>
<ref type="url">http://www.sorbonne-universite.fr/</ref>
</desc>
</hal:affiliation>
<country>France</country>
</affiliation>
</author>
<author>
<name sortKey="Mekinian, Arsene" sort="Mekinian, Arsene" uniqKey="Mekinian A" first="Arsène" last="Mékinian">Arsène Mékinian</name>
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<hal:affiliation type="institution" xml:id="struct-413221" status="VALID">
<orgName>Sorbonne Université</orgName>
<orgName type="acronym">SU</orgName>
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<country>France</country>
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</analytic>
<idno type="DOI">10.1016/j.autrev.2018.06.015</idno>
<series>
<title level="j">Autoimmunity Reviews</title>
<idno type="ISSN">1568-9972</idno>
<imprint>
<date type="datePub">2019</date>
</imprint>
</series>
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<profileDesc>
<textClass>
<keywords scheme="mix" xml:lang="en">
<term>DMARDS</term>
<term>Primary Sjögren's syndrome</term>
<term>Rituximab</term>
<term>Synovitis</term>
</keywords>
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<front>
<div type="abstract" xml:lang="en">
<p>OBJECTIVE: To describe the characteristics and the outcome of primary Sjögren Syndrome (pSS) associated arthritis and to compare the efficacy of different therapeutic regimen.METHODS: We conducted a retrospective study using Club Rhumatisme and Inflammation (CRI) and French Internal Medicine Society (SNFMI) networks. All patients with a diagnosis of pSS and at least one episode of clinical and/or echographic synovitis were included. Patients with synovitis (cases) were compared to pSS patients without synovitis (controls).RESULTS: 57 patients (93% women) were included with a median age of 54 years [45-63]. Patients with synovitis had more frequently lymph node enlargement (12.3% vs. 1.8%, p = .007) and a higher ESSDAI score (8 [6-12] vs. 2 [1-4], p < .0001). There was no difference concerning CRP levels, rheumatoid factor and cyclic citrullinated peptide (CCP)-antibodies positivity. Among 57 patients with synovitis, 101 various treatment courses have been used during the follow-up of 40 [22.5-77] months. First treatment course consisted in steroids alone (3.5%), steroids in association (79%) with hydroxychloroquine (HCQ) (49%), methotrexate (MTX) (35%), rituximab (RTX) (5.3%) or other immunosuppressive drugs (7%). HCQ, MTX, and RTX were associated with a significant reduction of tender and swollen joint count, and a significant steroids-sparing effect. No difference could be shown for the joint response between these treatment regimens.CONCLUSION: pSS articular manifestations may include synovitis which could mimic rheumatoid arthritis but differ by the absence of structural damage. Even if the use of HCQ, MTX, and RTX seem to be effective for joint involvement, the best regimen remains to be determined.</p>
</div>
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<hal api="V3">
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<title xml:lang="en">Arthritis in primary Sjögren's syndrome: Characteristics, outcome and treatment from French multicenter retrospective study</title>
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<persName>
<forename type="first">Adrien</forename>
<surname>Mirouse</surname>
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<persName>
<forename type="first">Raphaele</forename>
<surname>Séror</surname>
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<idno type="halauthorid">11562010</idno>
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<author role="aut">
<persName>
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<surname>HAL-SU</surname>
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<analytic>
<title xml:lang="en">Arthritis in primary Sjögren's syndrome: Characteristics, outcome and treatment from French multicenter retrospective study</title>
<author role="aut">
<persName>
<forename type="first">Adrien</forename>
<surname>Mirouse</surname>
</persName>
<idno type="halauthorid">1598075</idno>
<affiliation ref="#struct-541912"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Raphaele</forename>
<surname>Séror</surname>
</persName>
<idno type="halauthorid">11562010</idno>
<affiliation ref="#struct-18212"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Eric</forename>
<surname>Vicaut</surname>
</persName>
<email type="md5">0f71a011b2d2584198715ca4afbd1a68</email>
<email type="domain">lrb.aphp.fr</email>
<idno type="halauthorid">651912</idno>
<affiliation ref="#struct-26729"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Xavier</forename>
<surname>Mariette</surname>
</persName>
<email type="md5">00ea111c8153c0ee7167a0ab2a15897c</email>
<email type="domain">bct.aphp.fr</email>
<idno type="halauthorid">417928</idno>
<affiliation ref="#struct-312432"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Maxime</forename>
<surname>Dougados</surname>
</persName>
<email type="md5">21068e5fbe0089f66ef7c8640f94f50c</email>
<email type="domain">cch.aphp.fr</email>
<idno type="halauthorid">191437</idno>
<affiliation ref="#struct-18258"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Anne-Laure</forename>
<surname>Fauchais</surname>
</persName>
<email type="md5">5e4ecff62d5b0f71a325197b54afb720</email>
<email type="domain">chu-limoges.fr</email>
<idno type="halauthorid">422840</idno>
<affiliation ref="#struct-300906"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Alban</forename>
<surname>Deroux</surname>
</persName>
<email type="md5">c07d3c078eff503b91c2087e7dd41598</email>
<email type="domain">chu-grenoble.fr</email>
<idno type="halauthorid">1143288</idno>
<affiliation ref="#struct-257328"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Azeddine</forename>
<surname>Dellal</surname>
</persName>
<idno type="halauthorid">11523781</idno>
<affiliation ref="#struct-409419"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Nathalie</forename>
<surname>Costedoat-Chalumeau</surname>
</persName>
<idno type="halauthorid">822653</idno>
<affiliation ref="#struct-446175"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Guillaume</forename>
<surname>Denis</surname>
</persName>
<idno type="halauthorid">508550</idno>
<affiliation ref="#struct-13338"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Jeremie</forename>
<surname>Sellam</surname>
</persName>
<idno type="halauthorid">1390434</idno>
<affiliation ref="#struct-413221"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Jean-Benoît</forename>
<surname>Arlet</surname>
</persName>
<email type="md5">9a4c0fe2432747cb85008ea300c1d48f</email>
<email type="domain">egp.aphp.fr</email>
<idno type="halauthorid">769794</idno>
<affiliation ref="#struct-204525"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Christian</forename>
<surname>Lavigne</surname>
</persName>
<idno type="halauthorid">1299310</idno>
<affiliation ref="#struct-186833"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Geoffrey</forename>
<surname>Urbanski</surname>
</persName>
<idno type="halauthorid">11197141</idno>
<affiliation ref="#struct-186833"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Dominique</forename>
<surname>Fischer-Dumont</surname>
</persName>
<idno type="halauthorid">11523782</idno>
<affiliation ref="#struct-116551"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Abdou</forename>
<surname>Diallo</surname>
</persName>
<idno type="halauthorid">1434878</idno>
<affiliation ref="#struct-26729"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Olivier</forename>
<surname>Fain</surname>
</persName>
<idno type="halauthorid">555165</idno>
<affiliation ref="#struct-413221"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Arsène</forename>
<surname>Mékinian</surname>
</persName>
<idno type="halauthorid">11394852</idno>
<affiliation ref="#struct-413221"></affiliation>
</author>
</analytic>
<monogr>
<idno type="halJournalId" status="VALID">10938</idno>
<idno type="issn">1568-9972</idno>
<title level="j">Autoimmunity Reviews</title>
<imprint>
<publisher>Elsevier</publisher>
<biblScope unit="volume">18</biblScope>
<biblScope unit="issue">1</biblScope>
<biblScope unit="pp">9-14</biblScope>
<date type="datePub">2019</date>
<date type="dateEpub">2018-11-05</date>
</imprint>
</monogr>
<idno type="doi">10.1016/j.autrev.2018.06.015</idno>
<idno type="pubmed">30408585</idno>
</biblStruct>
</sourceDesc>
<profileDesc>
<langUsage>
<language ident="en">English</language>
</langUsage>
<textClass>
<keywords scheme="author">
<term xml:lang="en">Primary Sjögren's syndrome</term>
<term xml:lang="en">DMARDS</term>
<term xml:lang="en">Synovitis</term>
<term xml:lang="en">Rituximab</term>
</keywords>
<classCode scheme="halDomain" n="sdv.mhep.rsoa">Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system</classCode>
<classCode scheme="halDomain" n="sdv.spee">Life Sciences [q-bio]/Santé publique et épidémiologie</classCode>
<classCode scheme="halDomain" n="sdv.sp.pharma">Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology</classCode>
<classCode scheme="halTypology" n="ART">Journal articles</classCode>
</textClass>
<abstract xml:lang="en">
<p>OBJECTIVE: To describe the characteristics and the outcome of primary Sjögren Syndrome (pSS) associated arthritis and to compare the efficacy of different therapeutic regimen.METHODS: We conducted a retrospective study using Club Rhumatisme and Inflammation (CRI) and French Internal Medicine Society (SNFMI) networks. All patients with a diagnosis of pSS and at least one episode of clinical and/or echographic synovitis were included. Patients with synovitis (cases) were compared to pSS patients without synovitis (controls).RESULTS: 57 patients (93% women) were included with a median age of 54 years [45-63]. Patients with synovitis had more frequently lymph node enlargement (12.3% vs. 1.8%, p = .007) and a higher ESSDAI score (8 [6-12] vs. 2 [1-4], p < .0001). There was no difference concerning CRP levels, rheumatoid factor and cyclic citrullinated peptide (CCP)-antibodies positivity. Among 57 patients with synovitis, 101 various treatment courses have been used during the follow-up of 40 [22.5-77] months. First treatment course consisted in steroids alone (3.5%), steroids in association (79%) with hydroxychloroquine (HCQ) (49%), methotrexate (MTX) (35%), rituximab (RTX) (5.3%) or other immunosuppressive drugs (7%). HCQ, MTX, and RTX were associated with a significant reduction of tender and swollen joint count, and a significant steroids-sparing effect. No difference could be shown for the joint response between these treatment regimens.CONCLUSION: pSS articular manifestations may include synovitis which could mimic rheumatoid arthritis but differ by the absence of structural damage. Even if the use of HCQ, MTX, and RTX seem to be effective for joint involvement, the best regimen remains to be determined.</p>
</abstract>
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