{"id":14600,"date":"2021-04-30T08:25:44","date_gmt":"2021-04-30T06:25:44","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=14600"},"modified":"2024-12-11T13:06:59","modified_gmt":"2024-12-11T12:06:59","slug":"inhibition-de-la-dp-4-et-prevention-de-la-gvh-aigue","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/inhibition-de-la-dp-4-et-prevention-de-la-gvh-aigue\/","title":{"rendered":"Inhibition de la DP-4 et pr\u00e9vention de la GVH aigu\u00eb"},"content":{"rendered":"

R\u00e9f. : HematoStat.net ; 2 (1) : R8<\/p>\n

Dipeptidyl Peptidase 4 Inhibition for Prophylaxis of Acute Graft-versus-Host Disease<\/strong><\/em><\/p>\n

Farag, S. S. et al. Dipeptidyl Peptidase 4 Inhibition for Prophylaxis of Acute Graft-versus-Host Disease. N. Engl. J. Med. 384, 11\u201319 (2021).<\/span><\/i><\/div>\n
<\/div>\n
\n

R\u00e9sum\u00e9 :<\/h3>\n

Les auteurs ont inclus dans cet essai de phase 2, 36 patients cons\u00e9cutivement allogreff\u00e9s avec un donneur g\u00e9no ou ph\u00e9no-identique (conditionnement my\u00e9loablatif, cellules souches p\u00e9riph\u00e9riques). En compl\u00e9ment de la prophylaxie par sirolimus et tacrolimus, les patients recevaient la sitagliptine (inhibiteur de DP-4) \u00e0 la dose de 1200 mg\/jour la veille de la greffe et pendant 14 jours. L\u2019incidence de GVH aigu\u00eb II-IV (GVHa) \u00e0 J+100 \u00e9tait de 5% (IC95 % : 1-16).<\/p>\n<\/div>\n

Dans nos pratiques :<\/h3>\n

La GVHa demeure une complication importante de l\u2019allogreffe. Tentative de repositionnement ici d\u2019un m\u00e9dicament bien connu dans le traitement du diab\u00e8te, qui semble permettre de moduler la r\u00e9activit\u00e9 des lymphocytes T. Un m\u00e9dicament peu on\u00e9reux, facilement disponible et bien tol\u00e9r\u00e9 qui offre des r\u00e9sultats tr\u00e8s prometteurs avec un taux de GVHa extr\u00eamement faible sans impact, semble-t-il, sur le contr\u00f4le de la maladie.<\/p>\n

Le regard du statisticien :<\/strong><\/h3>\n

Cet essai de phase 2 a d\u00e9montr\u00e9 l\u2019int\u00e9r\u00eat de l\u2019association de la sitagliptine dans la r\u00e9duction de GVH aigu\u00eb de grade sup\u00e9rieur ou \u00e9gal \u00e0 II avec seulement 2 cas sur 36 patients de r\u00e9pertori\u00e9s, ce qui aboutit \u00e0 une tr\u00e8s faible incidence. \u00c9tant donn\u00e9 la dur\u00e9e de l\u2019\u00e9tude, les courbes de survie et d\u2019incidence permettent un follow-up <\/em>maximal sup\u00e9rieur \u00e0 3 ans. Il conviendra \u00e0 mon sens de confirmer ces r\u00e9sultats prometteurs avec un essai de phase 3 randomis\u00e9 en double aveugle par rapport \u00e0 un bras tacrolimus + sirolimus.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":16,"featured_media":14595,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[62,63],"ppma_author":[456],"class_list":["post-14600","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-gvh-aigue","tag-sitagliptine","author-alexis-genthon"],"aioseo_notices":[],"authors":[{"term_id":456,"user_id":16,"is_guest":0,"slug":"alexis-genthon","display_name":"Alexis GENTHON","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue.\r\nCorrespondance : H\u00f4pital Saint-Antoine \r\nService h\u00e9matologie clinique\r\n184 rue du Faubourg Saint-Antoine 75012 Paris."}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14600","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=14600"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14600\/revisions"}],"predecessor-version":[{"id":18175,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14600\/revisions\/18175"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=14600"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=14600"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=14600"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=14600"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}