, Annexe 2. : Serment d'Hippocrate Au moment d'être admis à exercer la médecine, je promets et je jure d'être fidèle aux lois de l'honneur et de la probité
, Mon premier souci sera de rétablir, de préserver ou de promouvoir la santé dans tous ses éléments, physiques et mentaux, individuels et sociaux
, Je respecterai toutes les personnes, leur autonomie et leur volonté, sans aucune discrimination selon leur état ou leurs convictions. J'interviendrai pour les protéger si elles sont affaiblies, vulnérables ou menacées dans leur intégrité ou leur dignité. Même sous la contrainte
, Admis dans l'intimité des personnes, je tairai les secrets qui me seront confiés
, J'apporterai mon aide à mes confrères ainsi qu'à leurs familles dans l'adversité
, Que les hommes et mes confrères m'accordent leur estime si je suis fidèle à mes promesses
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,
, RTX)) a montré son efficacité sur la prévention des récidives des poussées et la diminution du handicap dans le spectre des neuromyélites optiques (NMOSD), en particulier dans les formes séropositives pour les anticorps anti, p.4
, Dans les maladies associées aux anti-« Myelin oligodendrocyte glycoprotein » (MOGAD), il n'existe pas de consensus sur le traitement de fond et l'efficacité des anti-CD20 est débattue
Premièrement, l'objectif est de comparer l'efficacité clinique du RTX sur le risque de poussée et la diminution du handicap chez les NMOSD AQP4+ et les MOGAD. Deuxièmement, l'objectif est d'étudier l'efficacité d ,
Il s'agit d'une étude rétrospective multicentrique d'une population de patients adultes NMOSD (AQP4+, MOG+ et double séronégatifs) en Nouvelle-Aquitaine. Le critère de jugement principal était de comparer le délai de survenue d'une poussée après le début du RTX entre le groupe NMOSD AQP4+ et MOGAD, à l'aide d'une analyse de survie. Les critères secondaires étaient l'évolution du taux annuel de poussée (TAP) et de l' « Expanded disability status scale » (EDSS) en fonction du sous-type d'anticorps ,
A 1 an et à 2 ans de suivi, il existait respectivement 94,1% et 69% de patients libres de poussée dans le groupe AQP4+; 84% et 66,7% dans le groupe MOG+. Dans le groupe MOGAD, le TAP moyen diminue significativement après le début du RTX (TAP l'année précédente à 1,95, comparativement au TAP la première année à 0,16, et la deuxième année à 0,30). Les MOGAD améliorent également leur handicap lors du suivi avec une diminution de l'EDSS. Concernant l'efficacité des corticoïdes, il n'existe pas de différence significative sur le délai de survenue d, Quarante et un patients NMOSD ont été inclus : 17 AQP4 +, 19 MOG+ et 5 double séronégatifs ,
, Conclusion. L'efficacité clinique du RTX en termes de prévention de poussée et de diminution du handicap n'était pas différente chez les patients du groupe NMOSD AQP4+ et du groupe MOGAD dans notre étude
, Nos résultats suggèrent également l'absence d'efficacité d'une corticothérapie adjuvante au RTX sur le risque de poussée en début de traitement chez les patients NMOSD
, Thèse de doctorant en médecine, spécialité Neurologie Mots clés : Neuromyelitis optica spectrum disorder (NMOSD), Maladies associées aux anti-MOG, RITUXIMAB, Anticorps anti-aquaporine 4