{"id":11587,"date":"2024-09-16T12:39:54","date_gmt":"2024-09-16T12:39:54","guid":{"rendered":"https:\/\/oasis-trainingplatform.com\/articles\/congres-eular-2024-4-points-a-retenir-sur-la-prise-en-charge-de-larthrose\/"},"modified":"2024-09-18T09:33:42","modified_gmt":"2024-09-18T09:33:42","slug":"congres-eular-2024-4-points-a-retenir-sur-la-prise-en-charge-de-larthrose","status":"publish","type":"oasis-articles","link":"https:\/\/oasis-trainingplatform.com\/fr\/articles\/congres-eular-2024-4-points-a-retenir-sur-la-prise-en-charge-de-larthrose\/","title":{"rendered":"Congr\u00e8s EULAR 2024 : 4 points \u00e0 retenir sur la prise en charge de l\u2019arthrose"},"content":{"rendered":"\n

Efficacit\u00e9 \u00e0 long terme des interventions sur le mode de vie1<\/sup><\/h2>\n\n

Le Dr Carlijn Wagenaar a pr\u00e9sent\u00e9 l\u2019essai clinique randomis\u00e9 \u00ab Plants for Joints \u00bb (PFJ)2<\/sup>, qui a d\u00e9montr\u00e9 des am\u00e9liorations significatives chez les patients souffrant d\u2019arthrose de la hanche et du genou et du syndrome m\u00e9tabolique.L\u2019\u00e9tude de suivi \u00e0 deux ans a confirm\u00e9 que les r\u00e9ductions des scores de l\u2019indice WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) observ\u00e9es \u00e0 4 mois se maintenaient dans le temps, ce qui souligne les avantages \u00e0 long terme des interventions sur le mode de vie dans la gestion de l\u2019arthrose<\/strong>. <\/p>\n\n

Exploration de l\u2019axe intestin-articulation3<\/sup><\/h2>\n\n

La pr\u00e9sentation du Dr Daniele Mauro sur le r\u00f4le du microbiome dans l\u2019arthrose a mis en \u00e9vidence le concept de dysbiose du microbiote et sa corr\u00e9lation avec l\u2019inflammation intestinale et l\u2019arthrose4-12<\/sup>.<\/p>\n\n

L\u2019\u00e9tude a sugg\u00e9r\u00e9 que l\u2019inflammation intestinale pouvait atteindre les articulations par l\u2019interm\u00e9diaire des cellules immunitaires<\/strong> des muqueuses et que le microbiote produisait des facteurs pro-inflammatoires, contribuant ainsi \u00e0 l\u2019arthrose7,10,13-15<\/sup>. En outre, Mauro a attir\u00e9 l\u2019attention sur le fait qu\u2019il a \u00e9galement \u00e9t\u00e9 d\u00e9montr\u00e9 que la dysbiose de la muqueuse du tractus g\u00e9nital avait \u00e9galement un impact sur l\u2019arthrite16<\/sup>. La restauration de la perm\u00e9abilit\u00e9 intestinale s\u2019est av\u00e9r\u00e9e prometteuse dans des mod\u00e8les animaux, permettant potentiellement de pr\u00e9venir et de r\u00e9duire la gravit\u00e9 de l\u2019arthrite5,8,17<\/sup>. <\/p>\n\n

Ces r\u00e9sultats soulignent le r\u00f4le \u00e9mergent de l’axe intestin-articulation dans la pathogen\u00e8se de l’arthrose et d’autres maladies rhumatismales.<\/p>\n\n

Recommandations actualis\u00e9es sur la prise en charge non pharmacologique18<\/sup><\/h2>\n\n

Le professeur Nina Osteras a pr\u00e9sent\u00e9 une mise \u00e0 jour des recommandations de l\u2019EULAR pour la prise en charge non pharmacologique de l\u2019arthrose de la hanche et du genou19<\/sup>.<\/p>\n\n

Les principales recommandations portent sur l’\u00e9ducation th\u00e9rapeutique et les conseils sur les strat\u00e9gies d’autogestion, les programmes d’exercices personnalis\u00e9s, l’\u00e9ducation au maintien d\u2019un poids adapt\u00e9 et les techniques de changement de comportement, ainsi que sur l’utilisation d’appareils d’assistance et l’adaptation du lieu de travail.<\/p>\n\n

Les recommandations soulignent l’importance de l’\u00e9ducation et des conseils sur les strat\u00e9gies d’autogestion, ainsi que des plans<\/strong> de soins individualis\u00e9s, pour renforcer la participation du patient et r\u00e9duire la douleur.<\/p>\n\n

Identification des endotypes pathog\u00e8nes dans l\u2019arthrose20<\/sup><\/h2>\n\n

Le professeur Tonia Vincent a pr\u00e9sent\u00e9 les r\u00e9sultats du consortium STEP-uP OA21<\/sup>, qui a analys\u00e9 le liquide synovial de patients atteints d\u2019arthrose afin d\u2019identifier des endotypes mol\u00e9culaires.<\/p>\n\n

L’\u00e9tude a r\u00e9v\u00e9l\u00e9 qu’une part importante de la variance dans les \u00e9chantillons \u00e9tait due au score des prot\u00e9ines intracellulaires (IPS), et a identifi\u00e9 deux endotypes indistincts pr\u00e9sents<\/strong> dans l\u2019ensemble des donn\u00e9es de r\u00e9plication et de combinaison, qui \u00e9taient dus aux IPS<\/strong>. Ces endotypes n’ont pas \u00e9t\u00e9 observ\u00e9s lors de la r\u00e9gression de l’IPS. L’analyse du prot\u00e9ome a mis en \u00e9vidence une voie pathog\u00e8ne unique caract\u00e9ris\u00e9e par la transition \u00e9pith\u00e9lio-m\u00e9senchymateuse. L’identification de caract\u00e9ristiques ph\u00e9notypiques sp\u00e9cifiques aux patients peut permettre de les diff\u00e9rencier en partie et d\u2019ouvrir des approches de m\u00e9decine personnalis\u00e9e. <\/p>\n\n

Conclusion<\/h2>\n\n

Le congr\u00e8s EULAR 2024 a soulign\u00e9 l’importance d’une approche holistique de la recherche et de la prise en charge de l’arthrose, int\u00e9grant les interventions sur le mode de vie, et les d\u00e9couvertes scientifiques de pointe. Ces perspectives mettent en \u00e9vidence le potentiel de la m\u00e9decine personnalis\u00e9e et soulignent la n\u00e9cessit\u00e9 de poursuivre la recherche multidisciplinaire afin d’am\u00e9liorer les r\u00e9sultats pour les patients atteints d’arthrose. <\/p>\n\n

R\u00e9f\u00e9rences<\/h2>\n\n
    \n
  1. Wagenaar C. Long-term effectiveness of a lifestyle intervention for osteoarthritis: two-year follow-up after the \u201cPlants for Joints\u201d randomized clinical trial. OP0217. European Congress of Rheumatology: EULAR 2024; 2024 Jun 12-15, Vienna, Austria. <\/li>\n\n\n\n
  2. Walrabenstein W, Wagenaar CA, van de Put M, van der Leeden M, Gerritsen M, Twisk JWR, et al. A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the \u2018Plants for Joints\u2019 randomized controlled trial. Osteoarthritis Cartilage. 2023 Nov;31(11):1491\u2013500.<\/li>\n\n\n\n
  3. Mauro D. The Gut-Joint Axis: is it the microbiome? European Congress of Rheumatology: EULAR 2024; 2024 Jun 12-15, Vienna, Austria. <\/li>\n\n\n\n
  4. Sternes PR, Brett L, Phipps J, Ciccia F, Kenna T, de Guzman E, et al. Distinctive gut microbiomes of ankylosing spondylitis and inflammatory bowel disease patients suggest differing roles in pathogenesis and correlate with disease activity. Arthritis Res Ther. 2022 Jul 7;24(1):163. <\/li>\n\n\n\n
  5. Guggino G, Rizzo A, Mauro D, Macaluso F, Ciccia F. Gut-derived CD8+ tissue-resident memory T cells are expanded in the peripheral blood and synovia of SpA patients. Ann Rheum Dis. 2021 Nov;80(11):e174. <\/li>\n\n\n\n
  6. Costello ME, Ciccia F, Willner D, Warrington N, Robinson PC, Gardiner B, et al. Brief Report: Intestinal Dysbiosis in Ankylosing Spondylitis. Arthritis Rheumatol Hoboken NJ. 2015 Mar;67(3):686\u201391. <\/li>\n\n\n\n
  7. Gracey E, Vereecke L, McGovern D, Fr\u00f6hling M, Schett G, Danese S, et al. Revisiting the gut-joint axis: links between gut inflammation and spondyloarthritis. Nat Rev Rheumatol. 2020 Aug;16(8):415\u201333. <\/li>\n\n\n\n
  8. Tajik N, Frech M, Schulz O, Sch\u00e4lter F, Lucas S, Azizov V, et al. Targeting zonulin and intestinal epithelial barrier function to prevent onset of arthritis. Nat Commun. 2020 Apr 24;11(1):1995. <\/li>\n\n\n\n
  9. Wells PM, Adebayo AS, Bowyer RCE, Freidin MB, Finckh A, Strowig T, et al. Associations between gut microbiota and genetic risk for rheumatoid arthritis in the absence of disease: a cross-sectional study. Lancet Rheumatol. 2020 Jul;2(7):e418\u201327.<\/li>\n\n\n\n
  10. Ciccia F, Guggino G, Rizzo A, Alessandro R, Luchetti MM, Milling S, et al. Dysbiosis and zonulin upregulation alter gut epithelial and vascular barriers in patients with ankylosing spondylitis. Ann Rheum Dis. 2017 Jun;76(6):1123\u201332. <\/li>\n\n\n\n
  11. Kragsnaes MS, Kjeldsen J, Horn HC, Munk HL, Pedersen JK, Just SA, et al. Safety and efficacy of faecal microbiota transplantation for active peripheral psoriatic arthritis: an exploratory randomised placebo-controlled trial. Ann Rheum Dis. 2021 Sep;80(9):1158\u201367. <\/li>\n\n\n\n
  12. Wang Y, Wei J, Zhang W, Doherty M, Zhang Y, Xie H, et al. Gut dysbiosis in rheumatic diseases: A systematic review and meta-analysis of 92 observational studies. EBioMedicine. 2022 Jun;80:104055. <\/li>\n\n\n\n
  13. Mauro D, Thomas R, Guggino G, Lories R, Brown MA, Ciccia F. Ankylosing spondylitis: an autoimmune or autoinflammatory disease? Nat Rev Rheumatol. 2021 Jul;17(7):387\u2013404. <\/li>\n\n\n\n
  14. Scalise G, Ciancio A, Mauro D, Ciccia F. Intestinal Microbial Metabolites in Ankylosing Spondylitis. J Clin Med. 2021 Jul 29;10(15):3354. <\/li>\n\n\n\n
  15. Guggino G, Mauro D, Rizzo A, Alessandro R, Raimondo S, Bergot AS, et al. Inflammasome Activation in Ankylosing Spondylitis Is Associated With Gut Dysbiosis. Arthritis Rheumatol Hoboken NJ. 2021 Jul;73(7):1189\u201399. <\/li>\n\n\n\n
  16. Zhu N, Yang X, Liu Q, Chen Y, Wang X, Li H, et al. \u201cIron triangle\u201d of regulating the uterine microecology: Endometrial microbiota, immunity and endometrium. Front Immunol. 2022 Aug 9;13:928475. <\/li>\n\n\n\n
  17. Zaiss MM, Joyce Wu HJ, Mauro D, Schett G, Ciccia F. The gut-joint axis in rheumatoid arthritis. Nat Rev Rheumatol. 2021 Apr;17(4):224\u201337. <\/li>\n\n\n\n
  18. Osteras N. EULAR recommendations for the non-pharmacologial core management of hip and knee osteoarthritis: 2023 update. European Congress of Rheumatology: EULAR 2024; 2024 Jun 12-15, Vienna, Austria. <\/li>\n\n\n\n
  19. Moseng T, Vliet Vlieland TPM, Battista S, Beckw\u00e9e D, Boyadzhieva V, Conaghan PG, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update. Ann Rheum Dis. 2024 May 15;83(6):730\u201340. <\/li>\n\n\n\n
  20. Vincent T. Osteoarthritis: pathogenic endotypes. European Congress of Rheumatology: EULAR 2024; 2024 Jun 12-15, Vienna, Austria. <\/li>\n\n\n\n
  21. Perry TA, Deng Y, Hulley P, Maciewicz RA, Mitchelmore J, Larsson S, et al. Deconvoluting synovial fluid molecular endotypes in knee osteoarthritis: primary results from the STEpUP OA Consortium [Internet]. medRxiv; 2024 [cited 2024 Jul 31]. p. 2024.06.05.24308485. Available from: https:\/\/www.medrxiv.org\/content\/10.1101\/2024.06.05.24308485v2 <\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Le congr\u00e8s EULAR 2024 a rassembl\u00e9 des milliers d’experts et a \u00e9t\u00e9 le lieu de discussions marquantes concernant la recherche sur l’arthrose et la pratique clinique, telles que de nouvelles preuves sur l’efficacit\u00e9 des interventions \u00e0 long terme sur le mode de vie, le r\u00f4le \u00e9mergent du microbiome intestinal dans la sant\u00e9 des articulations, des recommandations actualis\u00e9es pour la prise en charge non pharmacologique, ou l’identification des endotypes dans l’arthrose… <\/p>\n

    D\u00e9couvrez ce que nous avons retenu de 4 conf\u00e9rences d\u00e9di\u00e9es \u00e0 l’arthrose qui ont eu lieu \u00e0 l’EULAR 2024, le congr\u00e8s europ\u00e9en de rhumatologie. <\/p>\n","protected":false},"featured_media":11583,"template":"","meta":{"_acf_changed":false,"_editorskit_title_hidden":false,"_editorskit_reading_time":0,"_editorskit_is_block_options_detached":false,"_editorskit_block_options_position":"{}","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}}},"class_list":["post-11587","oasis-articles","type-oasis-articles","status-publish","has-post-thumbnail","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/oasis-trainingplatform.com\/fr\/wp-json\/wp\/v2\/oasis-articles\/11587","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/oasis-trainingplatform.com\/fr\/wp-json\/wp\/v2\/oasis-articles"}],"about":[{"href":"https:\/\/oasis-trainingplatform.com\/fr\/wp-json\/wp\/v2\/types\/oasis-articles"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/oasis-trainingplatform.com\/fr\/wp-json\/wp\/v2\/media\/11583"}],"wp:attachment":[{"href":"https:\/\/oasis-trainingplatform.com\/fr\/wp-json\/wp\/v2\/media?parent=11587"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}