Docteur GUILLERMO CARVAJAL ALEGRIA

Thèses universitaires

• Effets pharmacodynamiques et pharmacocinétiques des biothérapies dans les maladies auto-immunes et inflammatoires

  2020

  Biotherapies’ mode of action and pharmacology in inflammatory and autoimmune diseases : tocilizumab and polymyalgia rheumatica

  Immunologie🎓 Brest

  Direction : Valérie Devauchelle-Pensec

Source : catalogue national des thèses theses.fr (ABES). Ne couvre que les doctorats / HDR — les thèses d'exercice (DES) sont archivées dans les SCD universitaires.

Bibliographie

• Maintenance of Remission After Tocilizumab Withdrawal in Patients With Glucocorticoid‐Dependent Polymyalgia Rheumatica

  2025

  ArticleArthritis & rheumatology

• Baricitinib in early polymyalgia rheumatica (BACHELOR): a randomised, double-blind, placebo-controlled, parallel-group trial

  2025

  ArticleThe Lancet Rheumatology

• Erratum à « Actualisation 2024 des recommandations de la Société française de rhumatologie pour le diagnostic et la prise en charge des personnes souffrant de polyarthrite rhumatoïde » [Rev. Rhum. 2024;91 (6):663–93]

  2025

  ArticleRevue du Rhumatisme

• GM-CSF drives IL-6 production by macrophages in polymyalgia rheumatica

  2025

  ArticleAnnals of the Rheumatic Diseases

• French protocol for the diagnosis and management of giant cell arteritis

  2025

  ArticleLa Revue de Médecine Interne

• Are ultrasound salivary parenchymal lesions more severe in primary Sjögren patients with a longer disease duration? A cross-sectional study

  2024

  ArticleRheumatology

• Use of immunosuppressants and biologics in giant cell arteritis: Recommendations of the French Study Group for Large Vessel Vasculitis (GEFA)

  2024

  ArticleLa Revue de Médecine Interne

• Development of a web-based ecological momentary assessment tool to measure day-to-day variability of the symptoms in patients with Sjögren’s disease

  2024

  ArticleRMD Open

Source : HAL — archive ouverte CCSD/CNRS (couvre articles, chapitres EMC, communications congrès, thèses).

Livres & ouvrages

• 📕

  Effets Pharmacodynamiques Et Pharmacocinétiques Des Biothérapies Dans Les Maladies Auto-immunes Et Inflammatoires

  20200

Source : Google Books — filtre catégories médicales/santé/sciences.

Localisation

Adresses géocodées via la Base Adresse Nationale (api-adresse.data.gouv.fr). Précision indicative.

Lieu de consultation

• CHRU TROUSSEAU - CHAMBRAY

  Avenue DE LA REPUBLIQUE, 37170 Chambray-lès-Tours

  ☎ 0247474747Hospitalier🏥 Voir cet établissement
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Tarifs & secteur de conventionnement

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Prendre rendez-vous & contact

Lien Doctolib = recherche Google site:doctolib.fr (le 1er résultat est presque toujours le profil correct s'il existe).

Top publications · les plus citées

• 1

  Epidemiology of neurological manifestations in Sjögren's syndrome: data from the French ASSESS Cohort

  RMD open · 2016

  📚 84 citations🎯 RCR 4.28Top 10% NIH🔓 Open Access📄 PDF gratuit ↗

  Lire l'abstract Crossref ↓

  Objectives Neurological manifestations seem common in primary Sjögren's syndrome (pSS) but their reported prevalences vary. We investigated the prevalence and epidemiology of neurological manifestations in a French nationwide multicentre prospective cohort of patients with pSS, the Assessment of Systemic Signs and Evolution in Sjögren's syndrome (ASSESS) cohort. Methods The ASSESS cohort, established in 2006, includes 395 patients fulfilling American–European Consensus Group criteria for pSS. Demographic and clinical data were compared between patient groups with and without neurological manifestations, and across patient groups with peripheral nervous system (PNS) manifestations, central nervous system (CNS) manifestations and no neurological manifestations. Results Data at inclusion were available for 392 patients, whose mean age was 58±12 years. Mean follow-up was 33.9 months. Neurological manifestations were present in 74/392 (18.9%) patients, including 63 (16%) with PNS manifestations and 14 (3.6%) with CNS manifestations. Prevalences were 9.2% for pure sensory neuropathy, 5.3% for sensorimotor neuropathy, 1.3% for cerebral vasculitis and 1.0% for myelitis. Neurological manifestations were associated with greater pSS activity as assessed using the ESSDAI (9.4±6.8 vs 4.3±4.8; p<0.001) and proportion of patients taking immunomodulatory/immunosuppressive drugs (32.4% (24/74) versus 13.8% (44/318), p=0003). New neurological symptoms were more common in patients with than without prior neurological manifestations (RR=3.918 (95% CI 1.91 to 8.05); p<0.001). Conclusions Prevalences of peripheral and central neurological manifestations in pSS are about 15% and 5%, respectively. Neurological manifestations are associated with greater pSS activity. New neurological manifestations are more common in patients with prior neurological involvement.

• 2

  A Risk Score to Detect Subclinical Rheumatoid Arthritis-Associated Interstitial Lung Disease

  Arthritis & rheumatology (Hoboken, N.J.) · 2022

  📚 83 citations🎯 RCR 9.25Top 3% NIH🔓 Open Access📄 PDF gratuit ↗

  Lire l'abstract Crossref ↓

  ObjectivePatients at high risk of rheumatoid arthritis–associated interstitial lung disease (RA‐ILD) would benefit from being identified before the onset of respiratory symptoms; this can be done by screening patients with the use of chest high‐resolution computed tomography (HRCT). Our objective was to develop and validate a risk score for patients who have subclinical RA‐ILD.MethodsOur study included a discovery population and a replication population from 2 prospective RA cohorts (ESPOIR and TRANSLATE2, respectively) without pulmonary symptoms who had received chest HRCT scans. All patients were genotyped for MUC5B rs35705950. After multiple logistic regression, a risk score based on independent risk factors for subclinical RA‐ILD was developed in the discovery population and tested for validation in the replication population.ResultsThe discovery population included 163 patients with RA, and the replication population included 89 patients with RA. The prevalence of subclinical RA‐ILD was 19.0% and 16.9%, respectively. In the discovery population, independent risk factors for subclinical RA‐ILD were presence of the MUC5B rs35705950 T allele (odds ratio [OR] 3.74 [95% confidence interval (95% CI) 1.37, 10.39]), male sex (OR 3.93 [95% CI 1.40, 11.39]), older age at RA onset (for each year, OR 1.10 [95% CI 1.04, 1.16]), and increased mean Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (for each unit, OR 2.03 [95% CI 1.24, 3.42]). We developed and validated a derived risk score with receiver operating characteristic areas under the curve of 0.82 (95% CI 0.70–0.94) for the discovery population and 0.78 (95% CI 0.65–0.92) for the replication population. Excluding MUC5B rs35705950 from the model provided a lower goodness of fit (likelihood ratio test, P = 0.01).ConclusionWe developed and validated a risk score that could help identify patients at high risk of subclinical RA‐ILD. Our findings support an important contribution of MUC5B rs35705950 to subclinical RA‐ILD risk.

• 3

  Effect of Tocilizumab on Disease Activity in Patients With Active Polymyalgia Rheumatica Receiving Glucocorticoid Therapy: A Randomized Clinical Trial

  JAMA · 2022

  📚 81 citations🎯 RCR 7.51Top 4% NIH🩺 Clinique🔓 Open Access📄 PDF gratuit ↗

  Lire l'abstract Crossref ↓

  ImportanceFew treatments are available for patients with glucocorticoid-dependent polymyalgia rheumatica. IL-6 antagonists may reduce disease activity in patients with active glucocorticoid-dependent polymyalgia rheumatica.ObjectiveTo compare the efficacy of tocilizumab vs placebo in patients with glucocorticoid-dependent polymyalgia rheumatica.Design, Setting, and ParticipantsThis double-blind, parallel-group, placebo-controlled randomized clinical trial enrolled 101 patients with polymyalgia rheumatica at 17 hospitals in France from February 2017 to October 2019. Final follow-up occurred in November 2020. Inclusion criteria were persistent disease activity (polymyalgia rheumatica activity score computed using the C-reactive protein level [CRP PMR-AS] >10) and prednisone dose greater than or equal to 10 mg per day.InterventionsPatients were randomly assigned to receive intravenous tocilizumab (8 mg/kg; n = 51) or placebo (n = 50) every 4 weeks for 24 weeks, combined with predefined standardized tapering of oral prednisone.Main Outcomes and MeasuresThe primary efficacy end point was CRP PMR-AS less than 10 (range, 0-100; higher values indicate greater activity; no minimal clinically important difference defined) combined with either prednisone dose less than or equal to 5 mg per day or a decrease in prednisone dose greater than or equal to 10 mg from baseline at week 24. There were 11 secondary outcomes assessed at week 24 included in this report, including disease activity (measured by CRP PMR-AS) and the proportion of patients no longer taking prednisone.ResultsOf the 101 randomized patients (mean age, 67.2 years; 68 [67.3%] women), 100 (99%) received at least 1 infusion and 100 completed the trial. The primary end point was achieved in 67.3% of patients in the tocilizumab group and 31.4% of patients in the placebo group (adjusted difference, 36.0% [95% CI, 19.4%-52.6%]; adjusted relative risk, 2.3 [95% CI, 1.5-3.6]; P < .001). Of 11 reported secondary end points at 24 weeks, 7 showed significant differences favoring tocilizumab, including mean CRP PMR-AS score (7.5 [95% CI, 5.4-9.6] vs 14.9 [95% CI, 11.4-18.4]; adjusted difference, −7.5 [95% CI, −11.2 to −3.8]; P < .001) and the percentage of patients no longer receiving prednisone (49.0% vs 19.6%; adjusted difference, 29.3% [95% CI, 18.9%-39.7%]; adjusted relative risk, 2.5 [95% CI, 1.8-3.5]; P < .001). The most frequent adverse events were infections, experienced by 23 patients (46.9%) in the tocilizumab group and 20 (39.2%) in the placebo group.Conclusions and RelevanceAmong patients with active polymyalgia rheumatica despite prednisone therapy, tocilizumab, compared with placebo, resulted in a significantly greater percentage of patients with a CRP PMR-AS less than 10 with reduced prednisone requirements at week 24. Further research is needed to confirm efficacy and to determine the balance of potential benefits and harms.Trial RegistrationClinicalTrials.gov Identifier: NCT02908217

Publications scientifiques (50) — classées par pathologie

Source PubMed · Recherche par auteur (homonymes possibles, vérifier l'affiliation).

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