📇 Rhumatologue · MONTIVILLIERS · (76) · Salarié

MME Louise DAMIAN

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Auteur de référence en rhumatologie
29 articles scientifiques publiés — un praticien à la pointe de la recherche
Délais de RDV courts dans la région
119.2 rhumatos / 100 000 hab. — département bien doté

Rhumatologue

📍 MONTIVILLIERS (76)SalariéRPPS 10101720208

Publications actives

5 publications sur 5 ans↗

📊 Reconnaissance scientifique : 6/100📝 10 articles publiés🇫🇷 Publications académiques françaises (6)

✨ Génération du profil synthétique IA en cours…

Données ANS publiques (Licence Ouverte 2.0) · Enrichissements MonRhumato 100 % opt-in · Toute personne référencée peut demander la suppression ou la rectification.

Top publications · les plus citées

Hydroxychloroquine reverses the prothrombotic state in a mouse model of antiphospholipid syndrome: Role of reduced inflammation and endothelial dysfunction

PloS one · 2019

📚 59 citations🎯 RCR 3.31Top 14% NIH🔓 Open Access📄 PDF gratuit ↗

Cyclophosphamide in combination with glucocorticoids for severe neuropsychiatric systemic lupus erythematosus: a retrospective, observational two-centre study

Lupus · 2016

📚 44 citations🎯 RCR 2.15Top 25% NIH🩺 Clinique

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Cyclophosphamide (CYC) is used in severe neuropsychiatric systemic lupus erythematosus (NPSLE), but long-term data regarding its efficacy and safety are lacking. We identified NPSLE cases who received CYC from two centres during the period 1999–2013 and had regular follow-up. General and neuropsychiatric outcome at last follow-up visit were determined, and major complications were documented. CYC was administered in 50 neuropsychiatric events. Median age was 45.0 years and 46% of patients were positive for antiphospholipid antibodies. Most frequent indications were psychosis (11 cases), polyneuropathy (six cases), and cerebrovascular disease, seizure disorder and cranial neuropathy (five cases). CYC was mainly administered as monthly pulses (median number: 8.0 (range 3–26), median cumulative dose: 7.2 g (range 2.4–33.8)). Cases were followed for a median of 46.5 months (range 5–408). At last follow-up, partial or complete response of NPSLE was observed in 84% of events; 10% had stable disease, whereas the remaining 6% failed to improve or worsened and were rescued with rituximab. In events that responded to CYC, maintenance therapy consisted of azathioprine in 31 events (65.9%), bimonthly or quarterly pulses of intravenous CYC in nine (19.1%), and mycophenolate mofetil in five (10.6%). Relapses were observed in six events (12%) at median eight months after initial response. No malignancies were observed, yet there were three cases of severe infections. Amenorrhea was recorded in three patients, who had not received gonadal protection. In conclusion, cyclophosphamide was efficacious and led to sustained response of severe NPSLE in a cohort with long follow-up.

EULAR recommendations for neuropsychiatric systemic lupus erythematosus vs usual care: results from two European centres

Rheumatology (Oxford, England) · 2015

📚 44 citations🎯 RCR 1.92🔓 Open Access📄 PDF gratuit ↗

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Abstract Objective To compare the European League Against Rheumatism (EULAR) recommendations for the management of NPSLE with usual care in two tertiary centres and to detect potential pitfalls in their use for diagnosis and treatment. Methods A chart-based review of NPSLE manifestations was conducted in two European centres. Diagnostic and treatment decisions were compared against the EULAR recommendations for general NPSLE and specific manifestations. Results We studied a total of 94 patients who experienced 123 lupus-related neuropsychiatric events over 10 years. In 80% of the events, at least one EULAR-defined risk factor (previous NPSLE, generalized disease activity or aPL positivity) was present. Overall, there was good concordance between clinical care and recommendations for diagnosis and treatment (68.7% and 62.7% of events, respectively). Brain MRI was performed in the absence of a clear EULAR recommendation in 42.9% of events; therein, it was more frequently normal compared with imaging performed according to the recommendations (52.4% vs 18.5%, P = 0.008), and it did not influence management. Among patients reporting cognitive dysfunction, only 27.8% underwent the recommended neuropsychological assessment. In line with the recommendations, immunosuppressants were more frequently given in events suggestive of an inflammatory process (80.5% vs 47.6% in non-inflammatory events, P &lt; 0.001). Notably, 52% of cerebrovascular events were managed with combined immunosuppressive/antithrombotic therapy due to either coexisting generalized lupus activity or recurrence despite prior antithrombotic treatment. Conclusion Despite good concordance between EULAR recommendations for NPSLE and usual clinical practice, we identified a number of issues (such as overutilization of brain MRI, suboptimal evaluation of cognitive dysfunction, and frequent use of immunosuppressives in cerebrovascular disease) that need to be investigated further.

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MME Louise DAMIAN

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Activité de recherche & publications

Publications académiques en France

Lieu de consultation

Tarifs & secteur de conventionnement

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Top publications · les plus citées

Publications scientifiques (29) — classées par pathologie

Transversal12

Revue générale4

Lupus3

SAPL3

Sjögren3

Vascularites des gros vaisseaux2

Case report / série1

csDMARDs1

Pédiatrie1

Revue / méta-analyse1

Vascularites1

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