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Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study

Identifieur interne : 000201 ( Ncbi/Merge ); précédent : 000200; suivant : 000202

Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study

Auteurs : R. Landewé [Pays-Bas] ; J. Braun [Allemagne] ; A. Deodhar [États-Unis] ; M. Dougados [France] ; W P Maksymowych [Canada] ; P J Mease [États-Unis] ; J D Reveille [États-Unis] ; M. Rudwaleit [Allemagne] ; D. Van Der Heijde [Pays-Bas] ; C. Stach [Allemagne] ; B. Hoepken [Allemagne] ; A. Fichtner [Allemagne] ; G. Coteur [Belgique] ; M. De Longueville [Belgique] ; J. Sieper [Allemagne]

Source :

RBID : PMC:3888598

Abstract

Objectives

To evaluate the efficacy and safety of certolizumab pegol (CZP) after 24 weeks in RAPID-axSpA (NCT01087762), an ongoing Phase 3 trial in patients with axial spondyloarthritis (axSpA), including patients with ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA).

Methods

Patients with active axSpA were randomised 1:1:1 to placebo, CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg every 4 weeks (Q4W). In total 325 patients were randomised. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society 20) response at week 12. Secondary outcomes included change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) linear.

Results

Baseline disease activity was similar between AS and nr-axSpA. At week 12, ASAS20 response rates were significantly higher in CZP 200 mg Q2W and CZP 400 mg Q4W arms versus placebo (57.7 and 63.6 vs 38.3, p≤0.004). At week 24, combined CZP arms showed significant (p<0.001) differences in change from baseline versus placebo in BASFI (−2.28 vs −0.40), BASDAI (−3.05 vs −1.05), and BASMI (−0.52 vs −0.07). Improvements were observed as early as week 1. Similar improvements were reported with CZP versus placebo in both AS and nr-axSpA subpopulations. Adverse events were reported in 70.4% vs 62.6%, and serious adverse events in 4.7% vs 4.7% of All CZP versus placebo groups. No deaths or malignancies were reported.

Conclusions

CZP rapidly reduced the signs and symptoms of axSpA, with no new safety signals observed compared to the safety profile of CZP in RA. Similar improvements were observed across CZP dosing regimens, and in AS and nr-axSpA patients.


Url:
DOI: 10.1136/annrheumdis-2013-204231
PubMed: 24013647
PubMed Central: 3888598

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PMC:3888598

Le document en format XML

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<title xml:lang="en" level="a" type="main">Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study</title>
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<name sortKey="Landewe, R" sort="Landewe, R" uniqKey="Landewe R" first="R" last="Landewé">R. Landewé</name>
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<addr-line>Amsterdam</addr-line>
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<country>The Netherlands</country>
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<country xml:lang="fr">Pays-Bas</country>
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<addr-line>Herne</addr-line>
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<country xml:lang="fr">Allemagne</country>
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<name sortKey="Deodhar, A" sort="Deodhar, A" uniqKey="Deodhar A" first="A" last="Deodhar">A. Deodhar</name>
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<institution>Oregon Health & Science University</institution>
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<addr-line>Portland, Oregon</addr-line>
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<country xml:lang="fr">États-Unis</country>
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<name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M" last="Dougados">M. Dougados</name>
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<nlm:aff id="af4">
<addr-line>Department of Rheumatology</addr-line>
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<addr-line>Paris</addr-line>
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<country>France</country>
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<country xml:lang="fr">France</country>
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<name sortKey="Maksymowych, W P" sort="Maksymowych, W P" uniqKey="Maksymowych W" first="W P" last="Maksymowych">W P Maksymowych</name>
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<addr-line>Department of Medicine</addr-line>
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<institution>University of Alberta</institution>
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<addr-line>Edmonton</addr-line>
,
<country>Canada</country>
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<country xml:lang="fr">Canada</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<name sortKey="Mease, P J" sort="Mease, P J" uniqKey="Mease P" first="P J" last="Mease">P J Mease</name>
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<nlm:aff id="af6">
<institution>Swedish Medical Center, University of Washington</institution>
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<addr-line>Seattle, Washington</addr-line>
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<country>USA</country>
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<country xml:lang="fr">États-Unis</country>
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<name sortKey="Reveille, J D" sort="Reveille, J D" uniqKey="Reveille J" first="J D" last="Reveille">J D Reveille</name>
<affiliation wicri:level="1">
<nlm:aff id="af7">
<addr-line>Division of Rheumatology</addr-line>
,
<institution>University of Texas Health Science Center at Houston</institution>
,
<addr-line>Houston, Texas</addr-line>
,
<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<name sortKey="Rudwaleit, M" sort="Rudwaleit, M" uniqKey="Rudwaleit M" first="M" last="Rudwaleit">M. Rudwaleit</name>
<affiliation wicri:level="1">
<nlm:aff id="af8">
<institution>Endokrinologikum Berlin</institution>
,
<addr-line>Berlin</addr-line>
,
<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
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<name sortKey="Van Der Heijde, D" sort="Van Der Heijde, D" uniqKey="Van Der Heijde D" first="D" last="Van Der Heijde">D. Van Der Heijde</name>
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<nlm:aff id="af9">
<addr-line>Department of Rheumatology</addr-line>
,
<institution>Leiden University Medical Centre</institution>
,
<addr-line>Leiden</addr-line>
,
<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<name sortKey="Stach, C" sort="Stach, C" uniqKey="Stach C" first="C" last="Stach">C. Stach</name>
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<nlm:aff id="af10">
<institution>UCB Pharma</institution>
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<addr-line>Monheim</addr-line>
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<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<name sortKey="Hoepken, B" sort="Hoepken, B" uniqKey="Hoepken B" first="B" last="Hoepken">B. Hoepken</name>
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<nlm:aff id="af10">
<institution>UCB Pharma</institution>
,
<addr-line>Monheim</addr-line>
,
<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<name sortKey="Fichtner, A" sort="Fichtner, A" uniqKey="Fichtner A" first="A" last="Fichtner">A. Fichtner</name>
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<nlm:aff id="af10">
<institution>UCB Pharma</institution>
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<addr-line>Monheim</addr-line>
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<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<name sortKey="Coteur, G" sort="Coteur, G" uniqKey="Coteur G" first="G" last="Coteur">G. Coteur</name>
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<nlm:aff id="af11">
<institution>UCB Pharma</institution>
,
<addr-line>Brussels</addr-line>
,
<country>Belgium</country>
</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="De Longueville, M" sort="De Longueville, M" uniqKey="De Longueville M" first="M" last="De Longueville">M. De Longueville</name>
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<institution>UCB Pharma</institution>
,
<addr-line>Brussels</addr-line>
,
<country>Belgium</country>
</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author>
<name sortKey="Sieper, J" sort="Sieper, J" uniqKey="Sieper J" first="J" last="Sieper">J. Sieper</name>
<affiliation wicri:level="1">
<nlm:aff id="af12">
<addr-line>Rheumatology Department</addr-line>
,
<institution>University Hospital Charité</institution>
,
<addr-line>Berlin</addr-line>
,
<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Annals of the Rheumatic Diseases</title>
<idno type="ISSN">0003-4967</idno>
<idno type="eISSN">1468-2060</idno>
<imprint>
<date when="2013">2013</date>
</imprint>
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<div type="abstract" xml:lang="en">
<sec>
<title>Objectives</title>
<p>To evaluate the efficacy and safety of certolizumab pegol (CZP) after 24 weeks in RAPID-axSpA (NCT01087762), an ongoing Phase 3 trial in patients with axial spondyloarthritis (axSpA), including patients with ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA).</p>
</sec>
<sec>
<title>Methods</title>
<p>Patients with active axSpA were randomised 1:1:1 to placebo, CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg every 4 weeks (Q4W). In total 325 patients were randomised. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society 20) response at week 12. Secondary outcomes included change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) linear.</p>
</sec>
<sec>
<title>Results</title>
<p>Baseline disease activity was similar between AS and nr-axSpA. At week 12, ASAS20 response rates were significantly higher in CZP 200 mg Q2W and CZP 400 mg Q4W arms versus placebo (57.7 and 63.6 vs 38.3, p≤0.004). At week 24, combined CZP arms showed significant (p<0.001) differences in change from baseline versus placebo in BASFI (−2.28 vs −0.40), BASDAI (−3.05 vs −1.05), and BASMI (−0.52 vs −0.07). Improvements were observed as early as week 1. Similar improvements were reported with CZP versus placebo in both AS and nr-axSpA subpopulations. Adverse events were reported in 70.4% vs 62.6%, and serious adverse events in 4.7% vs 4.7% of All CZP versus placebo groups. No deaths or malignancies were reported.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>CZP rapidly reduced the signs and symptoms of axSpA, with no new safety signals observed compared to the safety profile of CZP in RA. Similar improvements were observed across CZP dosing regimens, and in AS and nr-axSpA patients.</p>
</sec>
</div>
</front>
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<name sortKey="Baraliakos, X" uniqKey="Baraliakos X">X Baraliakos</name>
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<journal-id journal-id-type="iso-abbrev">Ann. Rheum. Dis</journal-id>
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<article-id pub-id-type="doi">10.1136/annrheumdis-2013-204231</article-id>
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</aff>
<aff id="af11">
<label>11</label>
<institution>UCB Pharma</institution>
,
<addr-line>Brussels</addr-line>
,
<country>Belgium</country>
</aff>
<aff id="af12">
<label>12</label>
<addr-line>Rheumatology Department</addr-line>
,
<institution>University Hospital Charité</institution>
,
<addr-line>Berlin</addr-line>
,
<country>Germany</country>
</aff>
<author-notes>
<fn>
<p>
<bold>Handling editor</bold>
Tore K Kvien</p>
</fn>
<corresp>
<label>Correspondence to</label>
Professor Robert Landewé, Department of Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam & Atrium Medical Center, Meibergdreef 9, Amsterdam 1105AZ, The Netherlands;
<email>landewe@rlandewe.nl</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>1</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>6</day>
<month>9</month>
<year>2013</year>
</pub-date>
<volume>73</volume>
<issue>1</issue>
<fpage>39</fpage>
<lpage>47</lpage>
<history>
<date date-type="received">
<day>4</day>
<month>7</month>
<year>2013</year>
</date>
<date date-type="rev-recd">
<day>19</day>
<month>8</month>
<year>2013</year>
</date>
<date date-type="accepted">
<day>20</day>
<month>8</month>
<year>2013</year>
</date>
</history>
<permissions>
<copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="open-access">
<license-p>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
</license-p>
</license>
</permissions>
<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="annrheumdis-2013-204231.pdf"></self-uri>
<related-article id="d35e376" related-article-type="companion" ext-link-type="doi" xlink:href="10.1136/annrheumdis-2013-203696"></related-article>
<related-article id="d35e377" related-article-type="companion" ext-link-type="doi" xlink:href="10.1136/annrheumdis-2013-203697"></related-article>
<abstract>
<sec>
<title>Objectives</title>
<p>To evaluate the efficacy and safety of certolizumab pegol (CZP) after 24 weeks in RAPID-axSpA (NCT01087762), an ongoing Phase 3 trial in patients with axial spondyloarthritis (axSpA), including patients with ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA).</p>
</sec>
<sec>
<title>Methods</title>
<p>Patients with active axSpA were randomised 1:1:1 to placebo, CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg every 4 weeks (Q4W). In total 325 patients were randomised. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society 20) response at week 12. Secondary outcomes included change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) linear.</p>
</sec>
<sec>
<title>Results</title>
<p>Baseline disease activity was similar between AS and nr-axSpA. At week 12, ASAS20 response rates were significantly higher in CZP 200 mg Q2W and CZP 400 mg Q4W arms versus placebo (57.7 and 63.6 vs 38.3, p≤0.004). At week 24, combined CZP arms showed significant (p<0.001) differences in change from baseline versus placebo in BASFI (−2.28 vs −0.40), BASDAI (−3.05 vs −1.05), and BASMI (−0.52 vs −0.07). Improvements were observed as early as week 1. Similar improvements were reported with CZP versus placebo in both AS and nr-axSpA subpopulations. Adverse events were reported in 70.4% vs 62.6%, and serious adverse events in 4.7% vs 4.7% of All CZP versus placebo groups. No deaths or malignancies were reported.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>CZP rapidly reduced the signs and symptoms of axSpA, with no new safety signals observed compared to the safety profile of CZP in RA. Similar improvements were observed across CZP dosing regimens, and in AS and nr-axSpA patients.</p>
</sec>
</abstract>
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<custom-meta>
<meta-name>special-feature</meta-name>
<meta-value>unlocked</meta-value>
</custom-meta>
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</article-meta>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Belgique</li>
<li>Canada</li>
<li>France</li>
<li>Pays-Bas</li>
<li>États-Unis</li>
</country>
</list>
<tree>
<country name="Pays-Bas">
<noRegion>
<name sortKey="Landewe, R" sort="Landewe, R" uniqKey="Landewe R" first="R" last="Landewé">R. Landewé</name>
</noRegion>
<name sortKey="Van Der Heijde, D" sort="Van Der Heijde, D" uniqKey="Van Der Heijde D" first="D" last="Van Der Heijde">D. Van Der Heijde</name>
</country>
<country name="Allemagne">
<noRegion>
<name sortKey="Braun, J" sort="Braun, J" uniqKey="Braun J" first="J" last="Braun">J. Braun</name>
</noRegion>
<name sortKey="Fichtner, A" sort="Fichtner, A" uniqKey="Fichtner A" first="A" last="Fichtner">A. Fichtner</name>
<name sortKey="Hoepken, B" sort="Hoepken, B" uniqKey="Hoepken B" first="B" last="Hoepken">B. Hoepken</name>
<name sortKey="Rudwaleit, M" sort="Rudwaleit, M" uniqKey="Rudwaleit M" first="M" last="Rudwaleit">M. Rudwaleit</name>
<name sortKey="Sieper, J" sort="Sieper, J" uniqKey="Sieper J" first="J" last="Sieper">J. Sieper</name>
<name sortKey="Stach, C" sort="Stach, C" uniqKey="Stach C" first="C" last="Stach">C. Stach</name>
</country>
<country name="États-Unis">
<noRegion>
<name sortKey="Deodhar, A" sort="Deodhar, A" uniqKey="Deodhar A" first="A" last="Deodhar">A. Deodhar</name>
</noRegion>
<name sortKey="Mease, P J" sort="Mease, P J" uniqKey="Mease P" first="P J" last="Mease">P J Mease</name>
<name sortKey="Reveille, J D" sort="Reveille, J D" uniqKey="Reveille J" first="J D" last="Reveille">J D Reveille</name>
</country>
<country name="France">
<noRegion>
<name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M" last="Dougados">M. Dougados</name>
</noRegion>
</country>
<country name="Canada">
<noRegion>
<name sortKey="Maksymowych, W P" sort="Maksymowych, W P" uniqKey="Maksymowych W" first="W P" last="Maksymowych">W P Maksymowych</name>
</noRegion>
</country>
<country name="Belgique">
<noRegion>
<name sortKey="Coteur, G" sort="Coteur, G" uniqKey="Coteur G" first="G" last="Coteur">G. Coteur</name>
</noRegion>
<name sortKey="De Longueville, M" sort="De Longueville, M" uniqKey="De Longueville M" first="M" last="De Longueville">M. De Longueville</name>
</country>
</tree>
</affiliations>
</record>

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