First data from the Severe Asthma Research cohort (RAMSES)

First data from the Severe Asthma Research cohort (RAMSES)
First data from the Severe Asthma Research cohort (RAMSES)

A study conducted by Dr. Solène Valéry within the Pharmacoepidemiology Center of AP-HP, of the PEPITES team of the Pierre Louis Institute of Epidemiology and Public Health (Inserm / Sorbonne University), was carried out on data from the RAMSES cohort, led by Camille Taillé, professor at the University of Paris Cité, and made it possible to directly compare for the first time two strategies for changing biotherapy. This work was published in the Journal of Allergy and Clinical Immunology.

In France, more than 60,000 people are affected by severe asthma. In recent years, the therapeutic offer has improved considerably with the arrival of monoclonal antibodies, biotherapies.

The RAMSES project, Research on Severe Asthma, is a prospective, multicenter, observational cohort epidemiological study that aims to assess in real life the treatment methods, benefits and/or risks associated with different treatments. Launched in 2019, and promoted by the Assistance Publique – Hôpitaux de Paris, the RAMSES cohort included 2,046 patients, followed in 52 centers across France.

By emulating a target clinical trial, it allowed for the first time to directly compare two strategies for changing biotherapy after failure of a first line with an anti IL-5 antibody: changing the class of molecule (for an anti IL-4R) or using another drug of the same class. Most patients benefit from changing the molecule, however changing the class is associated with a more marked reduction in the use of oral corticosteroids, a trend towards greater improvement in respiratory function and a decrease in exacerbations.

These data are important because they will help to better guide the therapeutic choice in the event of treatment failure.

This work follows the description of the cohort, carried out by Professor Jeanne-Marie Perotin (Reims University Hospital), published last April, which confirmed the importance of comorbidities linked to asthma and showed for the first time the heterogeneity of management of severe asthma in France, with in particular a lack of access to allergy investigations or therapeutic education. These data open up avenues of reflection to improve the management of these patients.

The scientific council approved several projects carried out using data from the RAMSES cohort by investigators, which should in the future contribute to a better understanding of the evolution of severe asthma under biotherapies.

The RAMSES cohort is led by Professor Camille Taillé (Pulmonology A department, Bichat – Claude-Bernard AP-HP hospital and Paris Cité University), Dr Candice Estellat (Pharmacoepidemiology Center, Pitié Salpêtrière AP-HP hospital), Professor Arnaud Bourdin (Montpellier University Hospital), Professor Cécile Chenivesse (Lille University Hospital), Professor Gilles Devouassoux (Hospices Civils de Lyon) and Professor Gilles Garcia (private hospital in Antony), on behalf of the French-Speaking Pneumology Society.

The coordination and methodology of the RAMSES cohort are provided by the AP-HP Pharmacoepidemiology Center (CEPHEPI).

It is made possible thanks to a financing agreement signed between the Assistance Publique – Hôpitaux de Paris and the Astrazeneca, GlaxoSmithKLine and Sanofi laboratories over five years, as well as support from the Société de Pneumologie de Langue Française and the Novartis laboratory.

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About AP-HP: The leading university hospital center (CHU) in Europe, AP-HP and its 38 hospitals are organized into six university hospital groups (AP-HP. Center – University Paris Cité; AP-HP. Sorbonne University; AP-HP. North – University Paris Cité; AP-HP. University Paris-Saclay; AP-HP. Henri-Mondor University Hospitals and AP-HP. Paris Seine-Saint-Denis University Hospitals) and are structured around five universities in the Paris region. Closely linked to major research organizations, AP-HP has eight world-class university hospital institutes (ICM, ICAN, IMAGINE, FOReSIGHT, PROMETHEUS, lnovAND, reConnect, THEMA) and the largest French health data warehouse (EDS). A major player in applied research and innovation in health, AP-HP holds a portfolio of 810 active patents, its clinical researchers sign more than 11,000 each year scientific publications and nearly 4,400 research projects are currently under development, across all sponsors. In 2020, AP-HP obtained the Carnot Institute label, which rewards the quality of partnership research: Carnot@AP-HP offers industrial players solutions in applied and clinical research in the field of health. In 2015, AP-HP also created the AP-HP Foundation, which works directly with caregivers to support the organization of care, hospital staff and research within AP-HP.



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