Real-World Data and Cohort Studies in Dermatology and Rhumatology
French Health-insurance IMIDs cohorts
We conduct nationwide, population-based cohort study using the French national health data system (Système National des Données de Santé [SNDS]). Thus, to assess efficacy and safety of therapeutic strategies, we use data of more than 400 000 patients with IMIDs who are treated with biological or targeted synthetic treatments.
For examples :
- 100 000 patients with rheumatoid arthritis.
Development and validation of a predictive model for the risk of serious infection in patients with rheumatoid arthritis initiating a biologic or targeted synthetic DMARD: a nationwide cohort study
https://doi.org/10.1093/rheumatology/keaf644
- 15 000 patients with psoriatic arthritis.
Influence of sex on the persistence of different classes of targeted therapies for psoriatic arthritis: a cohort study of 14 778 patients from the French health insurance database (SNDS)
https://doi.org/10.1136/rmdopen-2023-003570
- 50 000 patients with psoriasis.
Risk of Inflammatory Bowel Disease in Patients With Psoriasis and Psoriatic Arthritis/Ankylosing Spondylitis Initiating Interleukin-17 Inhibitors: A Nationwide Population-Based Study Using the French National Health Data System
https://doi.org/10.1002/art.41923
We update these data according to the research projects of the team members.
We are able to identify patients, to study treatment trajectories and outcomes of efficacy and safety thanks to outpatient and inpatient care information. Indeed, the SNDS covers 99% of the population living in France, 67 million individuals and contains individual and anonymized data: demographic data, outpatient drug dispensations, inpatient care information (admission date, length of stay, discharge hospitalisation diagnostic codes according to the International Classification of Diseases, 10th Revision [ICD-10], and procedures performed during the hospital stay according to the French medical classification for clinical procedures [CCAM]) and long-term disease (LTD) status, which allow for full coverage of health expenditures linked with the disease.
IMTEGRATE - Platform: structuring data to better understand inflammatory diseases
Epilogy team (Emilie Sbidian) with the Immuno-rheumatology Department (Raphaele Seror), Bicêtre Hospital (AP-HP) are launching the IMTEGRATE platform, which focuses on immune-mediated inflammatory diseases (IMIDs) such as rheumatoid arthritis, psoriasis and spondylitis. Drawing on its expertise in structuring data from the AP-HP Health Data Warehouse (EDS) and linking it to the SNDS, it will offer:
- The conduct of real-world epidemiological and pharmacoepidemiological studies through the creation of cohorts of patients with IMIDs.
- Access to cohort analyses enabling the assessment of the benefit/risk balance of IMID treatments in post-marketing phase IV, the evaluation of off-label treatments (common in dysimmune diseases), the provision of an external comparator arm or in silico research, the description of the severity of pathologies, and assistance with inclusion in randomised trials (identification of eligible patients).
- For industrial partners, methodological and statistical support, providing analyses of the care pathway, treatment consumption/penetration, tolerance and/or efficacy.
Systematic reviews and meta-analyses to assess benefit-to-risk balance for treatments for psoriasis
Since 2018, we have been conducting in collaboration with Cochrane skin a systematic living review and network meta-analysis to evaluate the relative efficacy and safety of all approved and investigational treatments for moderate to severe psoriasis
Systemic pharmacological treatments for chronic plaque psoriasis: a network meta‐analysis
https://doi.org/10.1002/14651858.CD011535.pub7
The most recent version published in 2025 included 207 trials and 67 889 participants.
In parallel, we are conducting a meta-analysis of individual data, which to date includes 70 of these trials, enabling us to enrich the results with efficacy and safety data based on patient characteristics. In addition, we are conducting a network meta-analysis based on both trial data and observational studies in order to obtain more complete data on serious adverse effects.
Serious adverse events associated with systemic treatments for psoriasis: a network meta‐analysis of observational studies and randomized controlled trials
https://doi.org/10.1002/14651858.CD015263
Aggregated data and IPD are necessary sources for recommendations on psoriasis treatment, the creation of databases for the construction of decision algorithms, and the conduct of meta-research studies aimed at improving the design and reporting of trials evaluating systemic treatment in psoriasis.
APACHE Cohort
We are conducting a national, multicenter prospective cohort study, the APACHE Cohort (A Psoriatic Arthritis CoHort) designed to characterize the early course of psoriatic arthritis in France (Pascal Claudepierre). The cohort aims to include 425 patients, and an analysis of the first 193 participants has already been published.
Very recent psoriatic arthritis: characteristics of the first 193 patients included in the APACHE cohort and influence of sex (French publication)
https://doi.org/10.1016/j.rhum.2024.10.313
DESIR Cohort
In parallel, our team is actively involved in other large-scale observational cohorts, notably the DESIR Cohort (French Cohort of Undifferentiated Spondyloarthritis, which follows 708 patients with axial spondyloarthritis and is planned to extend up to 20 years of follow-up. We serve on its Scientific Committee (Pascal Claudepierre, Laura Pina Vegas) as well as its Coordination Committee (Laura Pina Vegas).