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<publisher>HAL CCSD</publisher>
<title lang=en>Granulomatosis with polyangiitis: endoscopic management of tracheobronchial stenosis: results from a multicentre experience</title>
<creator>Terrier, Benjamin</creator>
<creator>Dechartres, Agnès</creator>
<creator>Girard, Charlotte</creator>
<creator>Jouneau, Stéphane</creator>
<creator>Kahn, Jean-Emmanuel</creator>
<creator>Dhote, Robin</creator>
<creator>Lazaro, Estibaliz</creator>
<creator>Cabane, Jean</creator>
<creator>Papo, Thomas</creator>
<creator>Schleinitz, Nicolas</creator>
<creator>Cohen, Pascal</creator>
<creator>Begon, Edouard</creator>
<creator>Belenotti, Pauline</creator>
<creator>Chauveau, Dominique</creator>
<creator>Diot, Elisabeth</creator>
<creator>Généreau, Thierry</creator>
<creator>Hamidou, Mohamed</creator>
<creator>Hayem, Gilles</creator>
<creator>Le Guenno, Guillaume</creator>
<creator>Le Guern, Véronique</creator>
<creator>Michel, Marc</creator>
<creator>Moulis, Guillaume</creator>
<creator>Puéchal, Xavier</creator>
<creator>Rivière, Sophie</creator>
<creator>Samson, Maxime</creator>
<creator>Gonin, François</creator>
<creator>Le Jeunne, Claire</creator>
<creator>Corlieu, Pascal</creator>
<creator>Mouthon, Luc</creator>
<creator>Guillevin, Loïc</creator>
<creator>Group, French Vasculitis Study</creator>
<contributor>Service de médecine interne et centre de référence des maladies rares [CHU Cochin] ; Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Cochin [AP-HP]</contributor>
<contributor>Institut Cochin (UM3 (UMR 8104 / U1016)) ; Université Paris Descartes - Paris 5 (UPD5) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Centre National de la Recherche Scientifique (CNRS)</contributor>
<contributor>Centre d'Epidémiologie Clinique ; Assistance publique - Hôpitaux de Paris (AP-HP) - Hôtel-Dieu - Université Paris Descartes - Paris 5 (UPD5) - PRES Sorbonne Paris Cité - French Cochrane Centre</contributor>
<contributor>Centre de recherches et d'études sur les droits fondamentaux (CREDOF) ; Centre de Théorie et Analyse du Droit (CTAD) ; École normale supérieure - Paris (ENS Paris) - École des hautes études en sciences sociales (EHESS) - Université Paris Nanterre (UPN) - Centre National de la Recherche Scientifique (CNRS) - Fédération interdisciplinaire de Nanterre en Droit (FIND) ; Université Paris Nanterre (UPN) - Université Paris Nanterre (UPN) - École normale supérieure - Paris (ENS Paris) - École des hautes études en sciences sociales (EHESS) - Université Paris Nanterre (UPN) - Centre National de la Recherche Scientifique (CNRS) - Fédération interdisciplinaire de Nanterre en Droit (FIND) ; Université Paris Nanterre (UPN) - Université Paris Nanterre (UPN)</contributor>
<contributor>Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )</contributor>
<contributor>Laboratoire d'Immunologie (EA 2686) ; Université de Lille, Droit et Santé</contributor>
<contributor>Service de Médecine Interne ; CHU Avicenne</contributor>
<contributor>Service de médecine interne et maladies infectieuses ; CHU Bordeaux [Bordeaux] - Groupe hospitalier Pellegrin</contributor>
<contributor>Service de médecine interne ; Université Pierre et Marie Curie - Paris 6 (UPMC) - Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Saint-Antoine [APHP]</contributor>
<contributor>Hôpital Bichat - Claude Bernard ; Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Bichat - Claude Bernard [Paris] - Université Paris Diderot - Paris 7 (UPD7)</contributor>
<contributor>Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )</contributor>
<contributor>CHU Cochin [AP-HP]</contributor>
<contributor>Service de Médecine Interne (MARSEILLE - Med Int) ; Assistance Publique - Hôpitaux de Marseille (APHM)</contributor>
<contributor>Département de Néphrologie et Transplantation d'organes ; CHU Toulouse [Toulouse] - Hôpital de Rangueil</contributor>
<contributor>Centre de référence des maladies rénales rares ; CHU Toulouse [Toulouse] - Hôpital de Rangueil</contributor>
<contributor>Institut des Maladies Métaboliques et Cardiovasculaires (I2MC) ; Université Paul Sabatier - Toulouse 3 (UPS) - Hôpital de Rangueil - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>Service de Médecine Interne ; Hôpital Bretonneau</contributor>
<contributor>Service de médecine interne [Nantes] ; Université de Nantes (UN) - Hôtel-Dieu - CHU Nantes</contributor>
<contributor>Service de Rhumatologie ; Hôpital Bichat - Claude Bernard [Paris] - Université Paris Diderot - Paris 7 (UPD7) - PRES Sorbonne Paris Cité - AP-HP</contributor>
<contributor>Service de médecine interne [Mondor] ; Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)</contributor>
<contributor>Service de Néphrologie - Médecine Interne ; CHU Amiens-Picardie - Hôpital Sud</contributor>
<contributor>Hôpital du Bocage ; Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)</contributor>
<contributor>Unité de Transplantation Pulmonaire ; Hôpital Foch [Suresnes]</contributor>
<contributor>CHU Tenon [APHP]</contributor>
<description>International audience</description>
<source>ISSN: 1462-0324</source>
<source>EISSN: 1460-2172</source>
<source>Rheumatology</source>
<publisher>Oxford University Press (OUP)</publisher>
<identifier>hal-01155105</identifier>
<identifier>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01155105</identifier>
<source>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01155105</source>
<source>Rheumatology, Oxford University Press (OUP), 2015, 54 (10), pp.1852-7. 〈10.1093/rheumatology/kev129〉</source>
<identifier>DOI : 10.1093/rheumatology/kev129</identifier>
<relation>info:eu-repo/semantics/altIdentifier/doi/10.1093/rheumatology/kev129</relation>
<identifier>PUBMED : 26001634</identifier>
<relation>info:eu-repo/semantics/altIdentifier/pmid/26001634</relation>
<language>en</language>
<subject>[SDV] Life Sciences [q-bio]</subject>
<type>info:eu-repo/semantics/article</type>
<type>Journal articles</type>
<description lang=en>OBJECTIVES: Tracheobronchial stenosis (TBS) is noted in 12-23% of patients with granulomatosis with polyangiitis (GPA), and includes subglottic stenosis and bronchial stenosis. We aimed to analyse the endoscopic management of TBS in GPA and to identify factors associated with the efficacy of endoscopic interventions. METHODS: We conducted a French nationwide retrospective study that included 47 patients with GPA-related TBS. RESULTS: Compared with patients without TBS, those with TBS were younger, more frequently female and had less frequent kidney, ocular and gastrointestinal involvement and mononeuritis multiplex. Endoscopic procedures included 137 tracheal and 50 bronchial interventions, mainly endoscopic dilatation, local steroid injection and conservative laser surgery, and less frequently stenting. After the first endoscopic procedure, the cumulative incidence of endoscopic treatment failure was 49% at 1 year, 70% at 2 years and 80% at 5 years. Factors significantly associated with a higher cumulative incidence of treatment failure were a shorter time from GPA diagnosis to endoscopic procedure [hazard ratio (HR) 1.08 (95% CI 1.01, 1.14); P = 0.01] and a bronchial stenosis [HR 1.96 (95% CI 1.28, 3.00); P = 0.002]. A prednisone dose ≥30 mg/day at the time of the procedure was associated with a lower cumulative incidence of treatment failure [HR 0.53 (95% CI 0.31, 0.89); P = 0.02]. CONCLUSION: TBS represents severe and refractory manifestations with a high rate of restenosis. High-dose systemic CSs at the time of the procedure and increased time from GPA diagnosis to bronchoscopic intervention are associated with a better event-free survival. In contrast, bronchial stenoses are associated with a higher rate of restenosis than subglottic stenosis.</description>
<date>2015</date>
</dc>
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