Efficacy and Safety of Rituximab in the Management of Pediatric Systemic Lupus Erythematosus: A Systematic Review.
Identifieur interne : 000394 ( Main/Exploration ); précédent : 000393; suivant : 000395Efficacy and Safety of Rituximab in the Management of Pediatric Systemic Lupus Erythematosus: A Systematic Review.
Auteurs : Ines Mahmoud [Tunisie] ; Manel Jellouli [Tunisie] ; Imen Boukhris [Tunisie] ; Rim Charfi [Tunisie] ; Aicha Ben Tekaya [Tunisie] ; Olfa Saidane [Tunisie] ; Maryem Ferjani [Tunisie] ; Yousra Hammi [Tunisie] ; Sameh Trabelsi [Tunisie] ; Narjess Khalfallah [Tunisie] ; Rawdha Tekaya [Tunisie] ; Tahar Gargah [Tunisie] ; Leila Abdelmoula [Tunisie]Source :
- The Journal of pediatrics [ 1097-6833 ] ; 2017.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Enfant (MeSH), Facteurs immunologiques (effets indésirables), Facteurs immunologiques (usage thérapeutique), Femelle (MeSH), Humains (MeSH), Jeune adulte (MeSH), Lupus érythémateux disséminé (traitement médicamenteux), Mâle (MeSH), Rituximab (effets indésirables), Rituximab (usage thérapeutique), Résultat thérapeutique (MeSH).
- MESH :
- effets indésirables : Facteurs immunologiques, Rituximab.
- traitement médicamenteux : Lupus érythémateux disséminé.
- usage thérapeutique : Facteurs immunologiques, Rituximab.
- Adolescent, Adulte, Enfant, Femelle, Humains, Jeune adulte, Mâle, Résultat thérapeutique.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Child (MeSH), Female (MeSH), Humans (MeSH), Immunologic Factors (adverse effects), Immunologic Factors (therapeutic use), Lupus Erythematosus, Systemic (drug therapy), Male (MeSH), Rituximab (adverse effects), Rituximab (therapeutic use), Treatment Outcome (MeSH), Young Adult (MeSH).
- MESH :
- chemical , adverse effects : Immunologic Factors, Rituximab.
- chemical , therapeutic use : Immunologic Factors, Rituximab.
- drug therapy : Lupus Erythematosus, Systemic.
- Adolescent, Adult, Child, Female, Humans, Male, Treatment Outcome, Young Adult.
Abstract
OBJECTIVES
To evaluate the efficacy and safety of rituximab for treating pediatric systemic lupus erythematosus (pSLE).
STUDY DESIGN
We performed a systematic review to evaluate the efficacy and safety of rituximab in children with pSLE. Data from studies performed before July 2016 were collected from MEDLINE, the Cochrane Library, Scopus, and the International Rheumatic Disease Abstracts, with no language restrictions. Study eligibility criteria included clinical trials and observational studies with a minimal sample size of 5 patients, regarding treatment with rituximab in patients with refractory pSLE (aged <18 years at the time of diagnosis). Independent extraction of articles was performed by 2 investigators using predefined data fields.
RESULTS
Twelve case series met the criteria for data extraction for the systematic review with a good quality assessment according to an 18-criteria checklist using a modified Delphi method. Among them, 3 studies were multicenter and 3 were prospective. The total number of patients was 272. Studies collected patients with active disease refractory to steroids and immunosuppressant drugs. Refractory lupus nephritis was the most common indication (33%). Acceptable evidence suggested improvements in renal, neuropsychiatric and haematological manifestations, disease activity, complement and anti-double stranded Desoxy-Nucleo-Adenosine, with a steroid-sparing effect. However, there was poor evidence suggesting efficacy on arthralgia, photosensitivity, and mucocutaneous manifestations of SLE in children. An overall acceptable safety profile with few major adverse events was shown.
CONCLUSION
Rituximab exhibited a satisfactory profile regarding efficacy and safety indicating that this agent is a promising therapy for pSLE and should be further investigated.
DOI: 10.1016/j.jpeds.2017.05.002
PubMed: 28602379
Affiliations:
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Olfa" uniqKey="Saidane O" first="Olfa" last="Saidane">Olfa Saidane</name><affiliation wicri:level="3"><nlm:affiliation>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Ferjani, Maryem" sort="Ferjani, Maryem" uniqKey="Ferjani M" first="Maryem" last="Ferjani">Maryem Ferjani</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Hammi, Yousra" sort="Hammi, Yousra" uniqKey="Hammi Y" first="Yousra" last="Hammi">Yousra Hammi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Trabelsi, Sameh" sort="Trabelsi, Sameh" uniqKey="Trabelsi S" first="Sameh" last="Trabelsi">Sameh Trabelsi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Pharmacology, National Centre of Pharmacovigilance, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Clinical Pharmacology, National Centre of Pharmacovigilance, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Khalfallah, Narjess" sort="Khalfallah, Narjess" uniqKey="Khalfallah N" first="Narjess" last="Khalfallah">Narjess Khalfallah</name><affiliation wicri:level="3"><nlm:affiliation>Department of Internal Medicine, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Internal Medicine, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement 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Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Abdelmoula, Leila" sort="Abdelmoula, Leila" uniqKey="Abdelmoula L" first="Leila" last="Abdelmoula">Leila Abdelmoula</name><affiliation wicri:level="3"><nlm:affiliation>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de 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Systemic Lupus Erythematosus: A Systematic Review.</title><author><name sortKey="Mahmoud, Ines" sort="Mahmoud, Ines" uniqKey="Mahmoud I" first="Ines" last="Mahmoud">Ines Mahmoud</name><affiliation wicri:level="3"><nlm:affiliation>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia. Electronic address: nefmhd@yahoo.fr.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Jellouli, Manel" sort="Jellouli, Manel" uniqKey="Jellouli M" first="Manel" last="Jellouli">Manel Jellouli</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Boukhris, Imen" sort="Boukhris, Imen" uniqKey="Boukhris I" first="Imen" last="Boukhris">Imen Boukhris</name><affiliation wicri:level="3"><nlm:affiliation>Department of Internal Medicine, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Internal Medicine, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Charfi, Rim" sort="Charfi, Rim" uniqKey="Charfi R" first="Rim" last="Charfi">Rim Charfi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Pharmacology, National Centre of Pharmacovigilance, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Clinical Pharmacology, National Centre of Pharmacovigilance, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Ben Tekaya, Aicha" sort="Ben Tekaya, Aicha" uniqKey="Ben Tekaya A" first="Aicha" last="Ben Tekaya">Aicha Ben Tekaya</name><affiliation wicri:level="3"><nlm:affiliation>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Saidane, Olfa" sort="Saidane, Olfa" uniqKey="Saidane O" first="Olfa" last="Saidane">Olfa Saidane</name><affiliation wicri:level="3"><nlm:affiliation>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Ferjani, Maryem" sort="Ferjani, Maryem" uniqKey="Ferjani M" first="Maryem" last="Ferjani">Maryem Ferjani</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Hammi, Yousra" sort="Hammi, Yousra" uniqKey="Hammi Y" first="Yousra" last="Hammi">Yousra Hammi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Trabelsi, Sameh" sort="Trabelsi, Sameh" uniqKey="Trabelsi S" first="Sameh" last="Trabelsi">Sameh Trabelsi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Pharmacology, National Centre of Pharmacovigilance, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Clinical Pharmacology, National Centre of Pharmacovigilance, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Khalfallah, Narjess" sort="Khalfallah, Narjess" uniqKey="Khalfallah N" first="Narjess" last="Khalfallah">Narjess Khalfallah</name><affiliation wicri:level="3"><nlm:affiliation>Department of Internal Medicine, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Internal Medicine, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Tekaya, Rawdha" sort="Tekaya, Rawdha" uniqKey="Tekaya R" first="Rawdha" last="Tekaya">Rawdha Tekaya</name><affiliation wicri:level="3"><nlm:affiliation>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Gargah, Tahar" sort="Gargah, Tahar" uniqKey="Gargah T" first="Tahar" last="Gargah">Tahar Gargah</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Abdelmoula, Leila" sort="Abdelmoula, Leila" uniqKey="Abdelmoula L" first="Leila" last="Abdelmoula">Leila Abdelmoula</name><affiliation wicri:level="3"><nlm:affiliation>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author></analytic><series><title level="j">The Journal of pediatrics</title><idno type="eISSN">1097-6833</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Child (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Immunologic Factors (adverse effects)</term><term>Immunologic Factors (therapeutic use)</term><term>Lupus Erythematosus, Systemic (drug therapy)</term><term>Male (MeSH)</term><term>Rituximab (adverse effects)</term><term>Rituximab (therapeutic use)</term><term>Treatment Outcome (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Enfant (MeSH)</term><term>Facteurs immunologiques (effets indésirables)</term><term>Facteurs immunologiques (usage thérapeutique)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Lupus érythémateux disséminé (traitement médicamenteux)</term><term>Mâle (MeSH)</term><term>Rituximab (effets indésirables)</term><term>Rituximab (usage thérapeutique)</term><term>Résultat thérapeutique (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Immunologic Factors</term><term>Rituximab</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Immunologic Factors</term><term>Rituximab</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Lupus Erythematosus, Systemic</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Facteurs immunologiques</term><term>Rituximab</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Lupus érythémateux disséminé</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Facteurs immunologiques</term><term>Rituximab</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Child</term><term>Female</term><term>Humans</term><term>Male</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Résultat thérapeutique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>To evaluate the efficacy and safety of rituximab for treating pediatric systemic lupus erythematosus (pSLE).</p></div><div type="abstract" xml:lang="en"><p><b>STUDY DESIGN</b></p><p>We performed a systematic review to evaluate the efficacy and safety of rituximab in children with pSLE. Data from studies performed before July 2016 were collected from MEDLINE, the Cochrane Library, Scopus, and the International Rheumatic Disease Abstracts, with no language restrictions. Study eligibility criteria included clinical trials and observational studies with a minimal sample size of 5 patients, regarding treatment with rituximab in patients with refractory pSLE (aged <18 years at the time of diagnosis). Independent extraction of articles was performed by 2 investigators using predefined data fields.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Twelve case series met the criteria for data extraction for the systematic review with a good quality assessment according to an 18-criteria checklist using a modified Delphi method. Among them, 3 studies were multicenter and 3 were prospective. The total number of patients was 272. Studies collected patients with active disease refractory to steroids and immunosuppressant drugs. Refractory lupus nephritis was the most common indication (33%). Acceptable evidence suggested improvements in renal, neuropsychiatric and haematological manifestations, disease activity, complement and anti-double stranded Desoxy-Nucleo-Adenosine, with a steroid-sparing effect. However, there was poor evidence suggesting efficacy on arthralgia, photosensitivity, and mucocutaneous manifestations of SLE in children. An overall acceptable safety profile with few major adverse events was shown.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Rituximab exhibited a satisfactory profile regarding efficacy and safety indicating that this agent is a promising therapy for pSLE and should be further investigated.</p></div></front></TEI><affiliations><list><country><li>Tunisie</li></country><region><li>Gouvernorat de Tunis</li></region><settlement><li>Tunis</li></settlement></list><tree><country name="Tunisie"><region name="Gouvernorat de Tunis"><name sortKey="Mahmoud, Ines" sort="Mahmoud, Ines" uniqKey="Mahmoud I" first="Ines" last="Mahmoud">Ines Mahmoud</name></region><name sortKey="Abdelmoula, Leila" sort="Abdelmoula, Leila" uniqKey="Abdelmoula L" first="Leila" last="Abdelmoula">Leila Abdelmoula</name><name sortKey="Ben Tekaya, Aicha" sort="Ben Tekaya, Aicha" uniqKey="Ben Tekaya A" first="Aicha" last="Ben Tekaya">Aicha Ben Tekaya</name><name sortKey="Boukhris, Imen" sort="Boukhris, Imen" uniqKey="Boukhris I" first="Imen" last="Boukhris">Imen Boukhris</name><name sortKey="Charfi, Rim" sort="Charfi, Rim" uniqKey="Charfi R" first="Rim" last="Charfi">Rim Charfi</name><name sortKey="Ferjani, Maryem" sort="Ferjani, Maryem" uniqKey="Ferjani M" first="Maryem" last="Ferjani">Maryem Ferjani</name><name sortKey="Gargah, Tahar" sort="Gargah, Tahar" uniqKey="Gargah T" first="Tahar" last="Gargah">Tahar Gargah</name><name sortKey="Hammi, Yousra" sort="Hammi, Yousra" uniqKey="Hammi Y" first="Yousra" last="Hammi">Yousra Hammi</name><name sortKey="Jellouli, Manel" sort="Jellouli, Manel" uniqKey="Jellouli M" first="Manel" last="Jellouli">Manel Jellouli</name><name sortKey="Khalfallah, Narjess" sort="Khalfallah, Narjess" uniqKey="Khalfallah N" first="Narjess" last="Khalfallah">Narjess Khalfallah</name><name sortKey="Saidane, Olfa" sort="Saidane, Olfa" uniqKey="Saidane O" first="Olfa" last="Saidane">Olfa Saidane</name><name sortKey="Tekaya, Rawdha" sort="Tekaya, Rawdha" uniqKey="Tekaya R" first="Rawdha" last="Tekaya">Rawdha Tekaya</name><name sortKey="Trabelsi, Sameh" sort="Trabelsi, Sameh" uniqKey="Trabelsi S" first="Sameh" last="Trabelsi">Sameh Trabelsi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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