📇 Rhumatologue · ROUEN · (76) · Hospitalier

MME CHRISTINE ARGELES-MANRIQUE

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Auteur de référence en rhumatologie
50 articles scientifiques publiés — un praticien à la pointe de la recherche
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Rhumatologue

📍 ROUEN (76)HospitalierRPPS 10001919405

✨ Génération du profil synthétique IA en cours…

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CABINET MEDICAL SUZANNE NOEL 66 AVENUE DE CAEN, 76100 ROUEN
☎ 0279492619Activité de soin et de pharmacie

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Top publications · les plus citées

Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl

JAMA network open · 2024

📚 38 citations🎯 RCR 12.81Top 2% NIH🔓 Open Access📄 PDF gratuit ↗

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ImportanceBuprenorphine treatment of opioid use disorder (OUD) is safe and effective, but opioid withdrawal during treatment initiation is associated with poor retention in care. As fentanyl has replaced heroin in the drug supply, case reports and surveys have indicated increased concern for buprenorphine-precipitated withdrawal (PW); however, some observational studies have found a low incidence of PW.ObjectiveTo estimate buprenorphine PW incidence and assess factors associated with PW among emergency department (ED) or hospitalized patients.Design, Setting, and ParticipantsThis retrospective cohort study at 3 academic hospitals in Philadelphia, Pennsylvania, included adults with OUD who underwent traditional or high-dose buprenorphine initiation between January 1, 2020, and December 31, 2021. Exclusion criteria included low-dose buprenorphine initiation and missing documentation of opioid withdrawal severity within 4 hours of receiving buprenorphine.ExposureBuprenorphine initiation with an initial dose of at least 2 mg of sublingual buprenorphine after a Clinical Opiate Withdrawal Scale (COWS) score of 8 or higher. Additional exposures included 4 predefined factors potentially associated with PW: severity of opioid withdrawal before buprenorphine (COWS score of 8-12 vs ≥13), initial buprenorphine dose (2 vs 4 or ≥8 mg), body mass index (BMI) (&amp;lt;25 vs 25 to &amp;lt;30 or ≥30; calculated as weight in kilograms divided by height in meters squared), and urine fentanyl concentration (0 to &amp;lt;20 vs 20 to &amp;lt;200 or ≥200 ng/mL).Main Outcome and MeasuresThe main outcome was PW incidence, defined as a 5-point or greater increase in COWS score from immediately before to within 4 hours after buprenorphine initiation. Logistic regression was used to estimate the odds of PW associated with the 4 aforementioned predefined factors.ResultsThe cohort included 226 patients (150 [66.4%] male; mean [SD] age, 38.6 [10.8] years). Overall, 26 patients (11.5%) met criteria for PW. Among patients with PW, median change in COWS score was 9 points (IQR, 6-13 points). Of 123 patients with confirmed fentanyl use, 20 (16.3%) had PW. In unadjusted and adjusted models, BMI of 30 or greater compared with less than 25 (adjusted odds ratio [AOR], 5.12; 95% CI, 1.31-19.92) and urine fentanyl concentration of 200 ng/mL or greater compared with less than 20 ng/mL (AOR, 8.37; 95% CI, 1.60-43.89) were associated with PW.Conclusions and RelevanceIn this retrospective cohort study, 11.5% of patients developed PW after buprenorphine initiation in ED or hospital settings. Future studies should confirm the rate of PW and assess whether bioaccumulated fentanyl is a risk factor for PW.

Buprenorphine Prescribing Characteristics Following Relaxation of X-Waiver Training Requirements

JAMA network open · 2024

📚 25 citations🎯 RCR 8.08Top 4% NIH🔓 Open Access📄 PDF gratuit ↗

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ImportanceLocal-level data are needed to understand whether the relaxation of X-waiver training requirements for prescribing buprenorphine in April 2021 translated to increased buprenorphine treatment.ObjectiveTo assess whether relaxation of X-waiver training requirements was associated with changes in the number of clinicians waivered to and who prescribe buprenorphine for opioid use disorder and the number of patients receiving treatment.Design, Setting, and ParticipantsThis serial cross-sectional study uses an interrupted time series analysis of 2020-2022 data from the HEALing Communities Study (HCS), a cluster-randomized, wait-list–controlled trial. Urban and rural communities in 4 states (Kentucky, Massachusetts, New York, and Ohio) with a high burden of opioid overdoses that had not yet received the HCS intervention were included.ExposureRelaxation of X-waiver training requirements (ie, allowing training-exempt X-waivers) on April 28, 2021.Main Outcomes and MeasuresThe monthly number of X-waivered clinicians, X-waivered buprenorphine prescribers, and patients receiving buprenorphine were each summed across communities within a state. Segmented linear regression models to estimate pre– and post–policy change by state were used.ResultsThe number of individuals in 33 participating HCS communities included 347 863 in Massachusetts, 815 794 in Kentucky, 971 490 in New York, and 1 623 958 in Ohio. The distribution of age (18-35 years: range, 29.4%-32.4%; 35-54 years: range, 29.9%-32.5%; ≥55 years: range, 35.7%-39.3%) and sex (female: range, 51.1%-52.6%) was similar across communities. There was a temporal increase in the number of X-waivered clinicians in the pre–policy change period in all states, which further increased in the post–policy change period in each state except Ohio, ranging from 5.2% (95% CI, 3.1%-7.3%) in Massachusetts communities to 8.4% (95% CI, 6.5%-10.3%) in Kentucky communities. Only communities in Kentucky showed an increase in the number of X-waivered clinicians prescribing buprenorphine associated with the policy change (relative increase, 3.2%; 95% CI, 1.5%-4.9%), while communities in other states showed no change or a decrease. Similarly, only communities in Massachusetts experienced an increase in patients receiving buprenorphine associated with the policy change (relative increase, 1.7%; 95% CI, 0.8%-2.6%), while communities in other states showed no change.Conclusions and RelevanceIn this serial cross-sectional study, relaxation of X-waiver training requirements was associated with an increase in the number of X-waivered clinicians but was not consistently associated with an increase in the number of buprenorphine prescribers or patients receiving buprenorphine. These findings suggest that training requirements may not be the primary barrier to expanding buprenorphine treatment.

Intraputaminal Delivery of Adeno-Associated Virus Serotype 2-Glial Cell Line-Derived Neurotrophic Factor in Mild or Moderate Parkinson's Disease

Movement disorders : official journal of the Movement Disorder Society · 2025

📚 11 citations🎯 RCR 4.67🩺 Clinique🔓 Open Access📄 PDF gratuit ↗

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AbstractBackgroundGlial cell line–derived neurotrophic factor (GDNF) is required for development and survival of dopaminergic neurons. A previous trial evaluating lower‐dose adeno‐associated virus serotype 2–GDNF (AAV2‐GDNF) bilateral intraputaminal infusion in participants with advanced Parkinson's disease (PD) achieved 26% mean putaminal coverage and was associated with stable motor features with no unexpected adverse events (AEs) over 60 months.ObjectiveWe assessed safety and preliminary clinical outcomes of optimized bilateral intraputaminal infusion of a single, higher dose of AAV2‐GDNF (product code AB‐1005) for PD after 18 months.MethodsThis phase 1b single‐arm, open‐label clinical trial enrolled participants with mild (Movement Disorder Society–revised Unified Parkinson's Disease Rating Scale [MDS‐UPDRS] Part III off score ≤ 32) and moderate (MDS‐UPDRS Part III off score of 33–60) PD. The primary outcome was safety. Clinical outcomes were assessed using PD‐specific clinical measures.ResultsEleven participants were enrolled (n = 6 mild; n = 5 moderate). Mean (±SE) putaminal coverage of AAV2‐GDNF was 63% (±2%). All participants experienced treatment‐emergent AEs (63 events); most were transient and perioperative. Six serious AEs in three participants were unrelated to AAV2‐GDNF. At 18 months posttreatment, the mild cohort exhibited numerically stable MDS‐UPDRS, motor diary, Unified Dyskinesia Rating Scale (UDysRS) scores, and levodopa equivalent daily dose (LEDD). The moderate cohort demonstrated numerical improvements in mean (±SE) MDS‐UPDRS Part III off scores (−20.4 [±4.5]), motor diary off time (−1.7 [±1.1] hours), and UDysRS scores (−2.2 [±1.9]) and reduced LEDD (−257.6 [±162.2] mg).ConclusionsBilateral intraputaminal AAV2‐GDNF gene therapy was well tolerated and associated with numerical stability (mild cohort) and improvement (moderate cohort) in clinical assessments at 18 months posttreatment. © 2025 AskBio Inc and The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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MME CHRISTINE ARGELES-MANRIQUE

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Top publications · les plus citées

Publications scientifiques (50) — classées par pathologie

Transversal29

Revue générale6

Qualité de vie / PROMs5

Épidémiologie & registres4

Pédiatrie4

Revue / méta-analyse4

Case report / série3

Corticothérapie1

Économie santé1

Essai clinique1

Génétique1

Microbiote1

Pharmacovigilance1

SAPL1

Vascularites des gros vaisseaux1

Vraie vie / RWE1

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