Étienne Rivière , Yann Nguyen , Noëlle Bernard , Nathalie Costedoat-Chalumeau , groupe Greenternist
{"title":"Connaître le coût financier et écologique pour rationaliser les prescriptions d’examens complémentaires ou de médicaments","authors":"Étienne Rivière , Yann Nguyen , Noëlle Bernard , Nathalie Costedoat-Chalumeau , groupe Greenternist","doi":"10.1016/j.revmed.2025.06.012","DOIUrl":"10.1016/j.revmed.2025.06.012","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 7","pages":"Pages 365-368"},"PeriodicalIF":0.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julie Moreau , Liticia Chikhoune , Claire Poggi , Sarah Stabler , Jean-Guillaume Letarouilly , Éric Hachulla , David Launay
{"title":"Safety profile of JAK inhibitors in inflammatory or autoimmune diseases","authors":"Julie Moreau , Liticia Chikhoune , Claire Poggi , Sarah Stabler , Jean-Guillaume Letarouilly , Éric Hachulla , David Launay","doi":"10.1016/j.revmed.2025.06.003","DOIUrl":"10.1016/j.revmed.2025.06.003","url":null,"abstract":"<div><div>Over the past decade, Janus kinase inhibitors (JAKi) have emerged as a promising treatment for inflammatory and autoimmune diseases. Concurrently, there has been increasing attention to their potential side effects, particularly infectious and cardiovascular risks. In this review, we outline the various adverse effects of these treatments and emphasize the importance of their prevention. First, we examine the risk of infection and the preventive measures through screening, vaccination, and prophylaxis. Subsequently, we explore the risk of developing malignant tumors, venous thromboembolism, and major cardiovascular events. Although the data are sometimes inconsistent, they indicate the existence of a subpopulation at increased risk of JAKi side effects, including patients over 65<!--> <!-->years of age, those with cardiovascular and malignancy risk factors, and smokers. Finally, we discuss the risk and prevention strategies for gastrointestinal perforation, as well as the risk of biological abnormalities, such as cytopenias, cytolysis, dyslipidemia, and elevated CPK levels.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 7","pages":"Pages 386-396"},"PeriodicalIF":0.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"L’upadacitinib : une (r)évolution pour la prise en charge de l’ACG ?","authors":"Maxime Samson, Hubert de Boysson","doi":"10.1016/j.revmed.2025.05.015","DOIUrl":"10.1016/j.revmed.2025.05.015","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 6","pages":"Pages 311-312"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thrombopénie immunologique induite par chimiothérapie : un coupable peut en cacher un autre","authors":"François Therme , Juliette Guiraud-Chaumeil , Géraldine Perkins , Margaux Lafaurie , Julien Maquet , Marie-Léa Piel-Julian , Sophie Voisin , Gérald Bertrand , Guillaume Moulis","doi":"10.1016/j.revmed.2025.03.427","DOIUrl":"10.1016/j.revmed.2025.03.427","url":null,"abstract":"<div><h3>Introduction</h3><div>Drug-induced immune thrombocytopenia (DIIT) is a rare cause of immune thrombocytopenia, characterized by the formation of drug-dependent antiplatelet antibodies. DIIT can lead to life-threatening hemorrhage. The diagnosis is difficult, relying on the detection of antiplatelet antibodies in patient's serum exclusively in the presence of the implicated drug. The gold standard test is the monoclonal antibody immobilization of platelet antigens (MAIPA), although other techniques (flow cytometry and Luminex®) can be used.</div></div><div><h3>Patients</h3><div>We report two cases of DIIT induced by both oxaliplatin and methylprednisolone.</div></div><div><h3>Results</h3><div>The two patients were undergoing chemotherapy for colon malignancy, receiving a regimen including oxaliplatin following premedication with methylprednisolone. Thrombocytopenia occurred within hours after one infusion (both patients had received prior courses with this regimen). Immunological tests for both patients revealed antiplatelet antibodies in the presence of oxaliplatin (anti-GPIIbIIIa in the first observation, and polytypic in the second one) and methylprednisolone (anti-GPIbV in the first observation and GPIIbIIIa in the second one). After the discontinuation of the implicated drugs (and treatment with prednisone plus intravenous immunoglobulin for the first patient), both patients showed rapid improvement in a few days. Both patients continued chemotherapy without oxaliplatin and methylprednisolone. No relapse was observed during the follow up.</div></div><div><h3>Conclusion</h3><div>DIIT are a rare cause of secondary immune thrombocytopenia. Diagnosis is complex, and the detection of drug-dependent antiplatelet antibodies in reference laboratories is essential. Oxaliplatin is a classical cause of DIIT. However, associated drugs like methylprednisolone can also be responsible for DIIT.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 6","pages":"Pages 313-319"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}