Jean Couret

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• Type de publi. : Article dans une revue
• Date de publi. : 01/04/2023
• Auteurs : Benjamin GalyMichael MusiMuriel HantcherliGuy MolénatAlain CouretPetra Spoerk-ErdelyHelmut ClemensJean-Philippe P Monchoux
• Organismes : Physique de la Plasticité et Métallurgie Montanuniversität Leoben Physique de la Plasticité et Métallurgie Physique de la Plasticité et Métallurgie Montanuniversität Leoben Montanuniversität Leoben Physique de la Plasticité et Métallurgie
• Publié dans Scripta Materialia le 29/10/2020

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Résumé : Dislocation velocities at high temperatures in metallic systems are believed in literature to be different for glide and climb, the values being bigger in case of glide. However, this has not been experimentally established. Therefore, in this study, dislocation velocities were measured with simultaneous determination of the corresponding mechanism (glide or mixed climb). For this purpose, coupled experiments of measurements of dislocation velocities by in-situ TEM investigations and of determination of movement planes by stereographic analyses have been carried out at 770-790°C in the  phase of an intermetallic Ti-48.4Al-0.1B (at.%) alloy. Mixed climb and pure glide mechanisms have thus been identified, both leading to dislocation velocities in the same order of magnitude (in the 0.5-5 nm/s range), showing that within a transition temperature domain, mixed climb can reach the velocity of glide.

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Fichiers liés : article_scripta_mat_submission_2.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 21/12/2022
• Auteurs : Guy MolénatJean-Philippe MonchouxMichael MusiPetra Spoerk-ErdelyHelmut ClemensAlain Couret
• Organismes : Centre d'élaboration de matériaux et d'études structurales Physique de la Plasticité et Métallurgie Centre d'élaboration de matériaux et d'études structurales Physique de la Plasticité et Métallurgie Montanuniversität Leoben Montanuniversität Leoben Montanuniversität Leoben Centre d'élaboration de matériaux et d'études structurales Physique de la Plasticité et Métallurgie
• Publié dans Scripta Materialia le 29/10/2020

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Résumé : The structure and mobility of a<001> dislocations in the β o phase of an intermetallic TNM-TiAl alloy produced by Spark Plasma Sintering were investigated by transmission electron microscopy. We find that these dislocations are dissociated into two identical superpartial dislocations separated by a stacking fault. Furthermore, a<001> dislocations are elongated along their screw orientation and anchored at small pining points assumed to be nanosized precipitates of the ω o phase. In situ room temperature straining experiments show that dislocation propagation occurs through jumps between these elongated configurations.

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Fichiers liés : CouretScripta2022 (7).pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 08/11/2022
• Auteurs : Michael MusiChristophe DeshayesGuy MolénatLouise ToualbiBenjamin GalyPetra Spoerk-ErdelyMuriel HantcherliJean-Philippe P MonchouxMarc ThomasHelmut ClemensAlain Couret
• Organismes : Montanuniversität Leoben Physique de la Plasticité et Métallurgie Physique de la Plasticité et Métallurgie DMAS, ONERA, Université Paris Saclay [Châtillon] Physique de la Plasticité et Métallurgie Montanuniversität Leoben Physique de la Plasticité et Métallurgie Physique de la Plasticité et Métallurgie DMAS, ONERA, Université Paris Saclay [Châtillon] Montanuniversität Leoben Physique de la Plasticité et Métallurgie
• Publié dans Metals le 21/10/2020

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Résumé : This work presents a study of the microstructure and mechanical properties of a TNM+ alloy (Ti-43.5Al-4Nb-1Mo-0.1B-0.3C-0.3Si, in at.%) densified by Spark Plasma Sintering (SPS), in comparison to the as-SPSed TNM alloy, which contains neither carbon nor silicon. Tensile tests at room temperature and 800 °C, as well as creep tests at 800 °C and 200 MPa, were performed. The microstructures and the fracture surfaces of deformed samples were studied by scanning and transmission electron microscopies, as well as by X-ray diffraction. The deformation mechanisms were investigated by means of in situ straining experiments and post-mortem analyses of deformed samples, both performed by transmission electron microscopy. Contrary to the TNM alloy, the as-SPSed microstructure of the TNM+ alloy does not contain β/βo phase due to the incorporation of carbon. At room temperature, the TNM+ alloy exhibits a yield stress of 520 MPa but a poor ductility of less than 0.1% of plastic strain. The incorporation of carbon and silicon leads to an increase in the creep resistance of the alloy at 800 °C. Despite the fact that iron inclusions are responsible for the premature failure of some samples during tensile tests, the TNM+ alloy is found to be able to deform plastically at room temperature by the glide of ordinary dislocations and by twinning.

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Fichiers liés : metals-12-01915-v2.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/05/2022
• Auteurs : David ReyesVirgil MalardStefan DrawinAlain CouretJean-Philippe P Monchoux
• Organismes : Centre d'élaboration de matériaux et d'études structurales DMAS, ONERA, Université Paris Saclay [Châtillon] DMAS, ONERA, Université Paris Saclay [Châtillon] Centre d'élaboration de matériaux et d'études structurales Centre d'élaboration de matériaux et d'études structurales
• Publié dans Intermetallics le 31/10/2020

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Résumé : The deformation mechanisms of an Nb–20Si–25Ti–6Al–3Cr–3Mo alloy deformed in compression at 1000 ◦C and at a strain rate of 10−4 s−1 have been investigated, using focused ion beam and transmission electron microscopy techniques. The initial microstructure of the alloy was constituted of a solid solution bcc Nbss matrix and of Nb5Si3 phases of β (tetragonal) and γ (hexagonal) crystallographic structures, with also hcp-Ti precipitates. As expected, the only phase which exhibited plastic deformation at 1000 ◦C was the Nbss matrix. Glide of Burgers vector b = 1/2 <111> dislocations has been observed, in planes compatible with {112} and {123} planes, or with cross-slip in {110} planes, as classically reported in bcc structures. Conversely, climb contribution has not been evidenced, probably because of rearrangement of the climbing dislocations in sub-boundaries. Fine δ-Nb11Si4 precipitates have been detected in the samples compressed at 1000 ◦C. Interactions of the δ-Nb11Si4 precipitates with the dislocations have been observed, which can potentially lead to strengthening of the Nbss phase.

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Fichiers liés : DMAS21126_PostPrint.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 03/03/2022
• Auteurs : Alain CouretJean-Jacques DaigreClément Barrillon
• Organismes : Université Paris 1 Panthéon-Sorbonne Institut de Recherche juridique de la Sorbonne André Tunc Université Paris 1 Panthéon-Sorbonne Institut de Recherche juridique de la Sorbonne André Tunc Centre de Droit Civil des Affaires et du Contentieux Economique
• Publié dans Recueil Dalloz le 29/10/2020

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• Type de publi. : Article dans une revue
• Date de publi. : 01/01/2022
• Auteurs : Michael MusiBenjamin GalyJean-Philippe P MonchouxAlain CouretHelmut ClemensSvea Mayer
• Organismes : Department of Materials Science, Montanuniversität Leoben, Franz-Josef-Straße 18, 8700 Leoben, Austria Centre d'élaboration de matériaux et d'études structurales Centre d'élaboration de matériaux et d'études structurales Centre d'élaboration de matériaux et d'études structurales Department of Materials Science, Montanuniversität Leoben, Franz-Josef-Straße 18, 8700 Leoben, Austria Department of Materials Science, Montanuniversität Leoben, Franz-Josef-Straße 18, 8700 Leoben, Austria
• Publié dans Scripta Materialia le 29/10/2020

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Résumé : Electromagnetic-assisted sintering offers the possibility for a time-efficient densification of intermetallic γ-TiAl based powders. Since the microstructure of the densified material and, thus, its mechanical properties can be controlled by the imposed temperature profile, the kinetics and transformations of the occurring phases are of particular interest. The present study describes a diffraction setup for the in-situ observation of the phase evolution by high-energy X-ray diffraction during an electromagnetic-assisted sintering process using induction heating. Starting from Ti-46.3Al-2.2W-0.2B powder (in at.%), this experiment grants time-resolved insights into the non-equilibrium and equilibrium phase transformations during this powder consolidation process for the first time. The microstructural accordance of the electromagnetic-assisted sintered specimen with spark plasma sintered material densified at the same dwell temperature highlights the transferability of both techniques and allows an allocation of the determined phase transformation data to the spark plasma sintering technology.

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Fichiers liés : Musi ScriptaMat.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/01/2022
• Auteurs : Marie Péan de Ponfilly-SotierVincent JachietYgal BenhamouConstance LahunaBenoit de RenzisDiane KottlerLaurent VoillatSophie Dimicoli-SalazarAnne BanosMarie-Paule ChauveheidJean-François AlexandraEric GrignanoFrançois LifermanMathilde LabordeJonathan BronerMarc MichelOlivier LambotteKamel LaribiMarie-Dominique VenonBertrand DussolNihal MartisSylvain ThepotSophie ParkDavid CouretMarielle Roux-SauvatLouis TerriouEric HachullaCécile BallyJoris GallandJean-Sébastien AllainAnne ParcelierPierre PeterlinJudith Cohen-BittanAlexis RegentFelix AckermannJulien Le GuenCaroline AlgrinPierre CharlesEtienne DaguindauXavier PuechalBertrand DunogueClaire Blanchard-DelaunayOdile Beyne-RauzyVincent GrobostJean SchmidtThomas Le GallouGeorgeta Dubos-LascuAnne SonetGuillaume DenisFrédérique Roy-PeaudPierre FenauxLionel AdèsOlivier FainArsène Mékinian
• Organismes : CHU Saint-Antoine [AP-HP] CHU Saint-Antoine [AP-HP] Endothélium, valvulopathies et insuffisance cardiaque CHU Saint-Antoine [AP-HP] Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital Centre d'Investigation Clinique [Rennes] CHU Saint-Antoine [AP-HP] CHU Saint-Antoine [AP-HP]
• Publié dans Clinical and experimental rheumatology le 31/10/2020

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Résumé : Objectives: Myelodysplastic syndromes (MDS) and chronic myelomonocytic leukaemia (CMML) are associated with systemic inflammatory and autoimmune diseases (SIADs) in 10-30% of cases. The aims of this study were (i) to evaluate the prevalence of venous thromboembolism VTE in patients presenting with both MDS/CMML and SIADs, (ii) to describe risk factors associated with thrombosis, and (iii) to analyse the impact of VTE on overall survival and transformation to acute myeloid leukaemia in comparison to patients with MDS/CMML-associated SIADs without VTE. Methods: This retrospective multicentre case-control study was conducted among patients with MDS/CMML and dysimmune disorders and featured in the French retrospective database of the French Network of Dysimmune Disorders Associated with Hemopathies (MINHEMON), diagnosed with MDS/CMML and dysimmune disorders. Results: During a median follow-up of 16 months (5-48) VTE occurred in 35 patients (21.6 %) whereas 127 patients did not. Among those with VTE, 8 patients (22.9%) experienced two or more VTE. Common prothrombotic risk factors were not significantly different in patients with or without VTE. CMML was more frequent in patients without VTE (37 % vs. 14.3%, p=0.01), whereas myelodysplasic/myeloproliferative neoplasm (MDS/MPN) was higher in VTE patients (20 % vs. 5.5 %, p=0.01). In a multivariate analysis, only MDS/CMML progression at the time of VTE (odds ratio 28.82, 95 % CI (5.52-530.70) was significantly associated with VTE. When treated with an anticoagulation therapy, bleeding occurred in 19.4% of cases (6/31). Overall survival was not significantly different between patients with and without VTE (p=0.68). Leukaemia-free survival between groups was not significantly different (p=0.83). Conclusions: VTE is a common complication in MDS/CMML-associated SIADSs with an increased risk of bleeding when treated by anticoagulants. In the MDS/CMML subgroup, SIADS flares and MDS/CMML progression seem to be prothrombotic risk factors.

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• Type de publi. : Article dans une revue
• Date de publi. : 01/01/2022
• Auteurs : Guy MolénatBenjamin GalyMichael MusiJean-Philippe P MonchouxLouise ToualbiHelmut ClemensMarc ThomasAlain Couret
• Organismes : Physique de la Plasticité et Métallurgie Physique de la Plasticité et Métallurgie Department Materials Science, Montanuniversität Leoben, Franz-Josef Str. 18, 8700 Leoben/ Austria Physique de la Plasticité et Métallurgie DMAS, ONERA, Université Paris Saclay [Châtillon] Department Materials Science, Montanuniversität Leoben, Franz-Josef Str. 18, 8700 Leoben/ Austria DMAS, ONERA, Université Paris Saclay [Châtillon] Physique de la Plasticité et Métallurgie
• Publié dans Intermetallics le 31/10/2020

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Résumé : In order to identify the reasons for the brittleness of a TNM-TiAl alloy (Ti51.05Al43.9Nb4Mo0.95B0.1 in at.%), the plastic deformation behaviour of the ordered beta-0 phase is investigated. The corresponding powder was densified by Spark Plasma Sintering to produce a near lamellar microstructure made of γ/α2 lamellar colonies surrounded by gamma and beta-0 grains. Then, the room temperature tensile behaviour is studied by carrying out tensile tests and additional in-situ straining experiments in a transmission electron microscope (TEM). The TNM alloy exhibits a limited ductility, with the fracture surface of test specimens showing cleavage facets along lamellar interfaces. In addition, the beta-0 grains contain nano-precipitates of the omega-0 phase and deform plastically by <111> superdislocations dissociated into two superpartial dislocations separated by an antiphase boundary. These dislocations glide in {011} planes and are observed to be localized into pileups, which is related to the omega-0 strengthening precipitation within the beta-0 grains. This localised hardening behaviour leads to stress concentration in grain boundaries which is assumed to be responsible for delamination along lamellar interfaces in neighbouring lamellar colonies.

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Fichiers liés : TNM beta phase.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/08/2021
• Auteurs : Alain CouretMelissa AllenMarcus Willi RackelBenjamin GalyJean- Philippe MonchouxVolker GütherFlorian PyczakPierre SallotMarc Thomas
• Organismes : Physique de la Plasticité et Métallurgie GfE Metalle and Materialien GmbH Helmholtz-Zentrum Geesthacht Centre d'élaboration de matériaux et d'études structurales Centre d'élaboration de matériaux et d'études structurales GfE Metalle and Materialien GmbH Helmholtz-Zentrum Geesthacht Safran Tech DMAS, ONERA, Université Paris Saclay [Châtillon]
• Publié dans Materialia le 23/10/2020

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Résumé : During the last decade, it has been shown that the W-containing IRIS-TiAl alloy displays promising properties for structural applications at high temperatures. The manufacturing process of this alloy is divided into three successive steps: electrode production, powder atomisation and spark plasma sintering (SPS) densification. However, an IRIS alloy densified by using pre-alloyed powders atomized by EIGA process (Electrode Induction melting Gas Atomisation) has recently been found to exhibit chemical heterogeneities. The aim of the present work is to look for the origin of such heterogeneities all along this manufacturing process. The microstructures and the chemical compositions of the material obtained after these different steps are thus investigated at intermediate and local scales by using various experimental tools. A particular attention is paid to the distribution of tungsten atoms in correlation to the constituent phases. Effects of these heterogeneities on mechanical properties are measured by performing tensile tests at room and high temperatures. It will be demonstrated that these heterogeneities are issued from tungsten segregation occurring during the first stage of the initial solidification of the electrode, thus prior to atomisation.

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Fichiers liés : CouretMateriala2021.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/06/2021
• Auteurs : Jérôme AvouacElodie DrumezEric HachullaRaphaèle SerorStéphanie Ducharme-BénardSoumaya El MahouEdouard PertuisetThao PhamHubert MarotteAmélie ServettazFanny DomontPascal ChazerainMathilde DevauxPascal ClaudepierreVincent LangloisArsène MekinianAlexandre Thibault Jacques MariaBéatrice BannevilleBruno FautrelJacques PouchotThierry ThomasRené-Marc FlipoChristophe RichezFlorence AeschlimannChristian AgardNassim Ait-AbdallahJean-David AlbertDidier AlcaisJean-Sébastien AllainYannick AllanoreBlanca Amador-BorreiroZahir AmouraEmma AndreAnaïs ArbaultJean-Benoît ArletLaurent ArnaudDenis ArniaudHerliette Arty-HueLucie AtlanAlexandra Audemard-VergerChristine Audoin-PajotVictor AudrenMaxime Bach-BunnerHélène Bacquet-DeschryverBrigitte Bader-MeunierNathalie BalandraudJean-Charles BalblancStéphane BallyFrédéric BanalPierre BarberyThomas BarnetcheAudre BarreletAndré BaschVincent BaumierGuillaume BayerSophie BayleCatherine BeauvaisRudie BeinatVéronique BelinRakiba BelkhirRuben BenainousAlexandre BelotMohammed BenammarMathilde BenhamouYgal BenhamouAhmed BenmansourPascal BennetBrigitte Bernoux-ManatElise BerthetEmilie BerthouxEwa BertoliniAdrien BigotAurélia Bisson-VaivreGilles BlaisonGilles BollaOlivier BonidanChristine BonnetRaphaël BorieMarie BossertLaurence BoudouFrançoise BouhourKévin BouillerBastien BouldoiresKarima BoussoualimEric BouvardRegine BrondinoPierre BuchlinLaurence CabantousPatrice CacoubSimon CadiouMaurizio CarteniAurélia CarbasseBrice CastelPascal CathebrasHervé CaumontAnnalisa CelantBenjamin ChaigneBenoît ChaillousRomuald ChampyAgnès CharcotPierre CharlesIsabelle Charlot-LambrechtCaroline CharpinEmmanuel ChatelusBernard ChaudierPascale ChertokXavier ChevalierMaxime ChevreauEmilie ChotardDelphine Chu Miow LinGaëlle ClavelCyril Clavel-OsorioFleur CohenGregory CohenMarie-Eve Colette-CedozNived CollercandyAntoine ColombeyChloé ComarmondBernard CombeCéline ComparonElodie ConstantPascal CoquerelleJustine CorliClémence CorreNathalie Costedoat-ChalumeauMarie CouretNatacha CourvoisierFabienne Coury-LucasCécile CoutarelFabrice CoutierRichard DamadeLaurence Daver-MalaterreSarahe DehimatMichel DelahousseEmilie Barrois-DelattreDelphine DenarieCamille DeprouwEmanuelle DernisAlban DerouxRenaud DesbarbieuxElise DescampsChantal DeslandreMarie DesmursJacques DespauxMarie DesplatsFrédérick DetreeValérie Devauchelle-PensecRobin DhotePhilippe DieudeYannick DieudonneElisabeth DiotGuillaume DirezDjamal-Dine DjeddiSarah DouvierBéatrice DrouetCatherine DucAngélique DucornetCarine Dufauret-LombardAlain DuhamelCécile DumaineAnne-Elisabeth DumelChantal Dumoulin-RichezAgnès DuquesneGéraldine DurandMariane Durandin-TruffinetPierre-Marie DuretMaïka DuvalMikaël EbboEsther EbsteinAndra Economu-DuboscStéphanie EmilieRomain EuvrardPhilippe EvonSylvie FabreDorothée FagedetMeryem FarhatMarion FauconierJacques FechtenbaumRenaud FeltenFanny FernandesNicole Ferreira-MaldentElodie FeurerAmandine FichetFrançoise FlaislerNans FlorensViolaine FoltzElisabeth FontangesJennifer ForetAnne-Claire FougerousseAnne Fouque-AubertCatherine Foutrier-MorelloHélène Francois-PradierLéa FrantzenPierre FritzAntoine FroissartJean FulpinPiera FuzibetFrancis GachesLaurence Gagneux-LemoussuMélanie Penhoat-GahierJoris GallandFrédérique GandjbakhchNicole GarnierThomas GarraudJean-François GarrotRomain GastaldiVéronique Gaud-ListratMaud Gauthier-PrieurDana GeorgescuNathalie GerardElisabeth Solau-GervaisChristelle GibertEric GibertGhislaine GillJérôme GillardMélanie GilsonPauline GimonnetJeanine-Sophie Giraudet-Le QuintrecAude Giraud-MoreletBaptiste GlaceCamille GlanowskiBertrand GodeauBruno GombertCamille Gonnet-GraciaTiphaine GoulenokPhilippe GoupilleOlivier GourmelenSophie Govindaraju-AudouardFranck GradosMartine Grall-LeroseyBruno GrardelAnne GraslandGilles GrateauMonica GrozaConstance GuillaudSéverine GuillaumeCaroline GuillibertXavier GuillotPhilippe GuilpainAline GuryMarie-Hélène GuyotCécile Hacquard-BouderMarie-Noelle HavardJean-Pierre HellierPascal HennequinBasile HenriotJulien HenryVéronique HentgenMarion HermetMuriel HerasseJulie HernandezMiguel HiePascal HilliquinOlivier HinschbergerAmbre Hittinger-RouxJan HolubarChristophe HudrySerge HuguenelClara JaccardJean-Michel, JacquemierBénédicte JamardCatherine JanSylvie JeanMathieu JouvrayPierre-Antoine JugeLaurent JuillardDenis JullienAnna KabalaAbdelkrim KabchouLudovic KarkowskiFrançoise KarmanFarid KemicheJérémy KeraenPierre KiefferIsabelle Kone-PautAbdeldajallil KoreichiMarie KostineSylvain La Batide AlanorePierre LafforgueSophie LahalleMarc LambertIsabelle LambrechtSylvain LanotAurélia LanteriJean-Paul LarbreAugustin LatourteChristian LavigneSophie Le Guen GueganGuillaume, Le GuennoDiane LeguyAgnès LebrunEmmanuel LedoultNathalie LegoupilErick LegrandCharlotte LejeuneOlivier LeloireChristophe LerouxRémi LeroyMarie Leroy-GouixTifenn LeturcqAmélie LeursCéline Leveque-MichaudFrançois-Xavier LimbachFrédéric LioteAnne LohsePierre Lozac'HVirginie LucasAurélie MadelonNadine Magy-BertrandMatthieu MahevasHélène MaillardThibault MailletSandrine Malochet-GuinamandQuentin MangonSylvie Marchou-LopezNathalie MargaritThierry MarhadourXavier MarietteClaire MartinAlexis MathianFrançois MaurierFrédéric MauryBetty Mazet-GuillaumeArnaud MazouyezHassan MazyadNadia Mehsen-CetreUlrich MeinzerIsabelle MelkiLaurent MesserCorinne MiceliMartin MichaudCatherine MichelMatthias MichelMathilde MichonAnne-Marie Milesi-LecatAnna MoltóMarie MolyOlivier MoranneGautier MorelHugo MorelJacques MorelFranck MorinLaurence MoulinierGuillaume MoulisBertrand MouraMinh NguyenSabine Nicolas-VulliermeHubert NiellyGaétane NocturneAurore NottezHenri-Olivier OllagnonIsabelle Pacaud-VitouxAnne PagnierCaroline ParisAntoine ParrotTristan PascartYasmina Pascaud-MansourLætitia PaulinStephan PavyLaurent PerardYves-Marie PersMicheline PhaMaud PichonAudrey PierreisnardGabrielle PizanaSylvaine PoignantElsa PoixAgnès PortierAntoine PouletSamira PlassardGrégory PugnetDéborah Puyraimond-ZemmourPierre Quartier-Dit-MaireMarion QuenetViviane QueyrelLoïc RaffrayPhilippe RemyMyriam RenardJessica ReneSabine RevuzBénédicte ReyGaëlle Richard-ColmantEtienne RiviereSébastien RiviereSophie RobinJulien RohmerIsabelle RoitgMélanie RomierMichel RollandMélanie RorizCarole RosenbergLinda RossiOlivier RothSid-Ahmed RouidiMathilde RoumierMickaël RousiereClémentine RousselinBénédicte RouviereChristian RouxFabienne RouxMarielle RouxNicolas RouxDiane RouzaudSylvie RozenbergIsabelle SaccoFatiha SadjiLaurent SaillerCarine SalliotJean-Hugues SalmonAlain SarauxJean SchmidtJulie SeguierJérémie SellamEric SenbelThomas SenePatricia SenetPascal SeveAurélie SicaudPerrine SmetsVincent SobanskiChristelle SordetElisabeth Sornay-RenduOdile Souchaud-DebouverieLætitia SparsaLionel SpielmannSarah SteibChloé StavrisCatherine StrausVictor StrotzPaulina SzaforsSéverine Taffignon-ClaveJustine SimoensClaire TheillacNora TenenbaumBenoît ThomachotNathalie TieulieSoizic TiriauAlice TisonEric ToussirotLudovic TrefondSophie TrijauSébastien TrouillierAnne-Priscille TrouvinMarie-Elise TruchetetMarc UlrichJacques VaquierEric VeillardLaurent VeillonGuillaume VialJean-François ViallardJudith VictorClaire VidonMathias VidonCamille VigneAlexandre VironeUrsula WarzochaDaniel WendlingClaude WerleCécile WibauxAlexandra WillemsMichel WisniewskiJuliette WoessnerBernadette Xerri-Campano
• Organismes : Service de rhumatologie [CHU Cochin] Evaluation des technologies de santé et des pratiques médicales - ULR 2694 Service de médecine interne [Lille] Institute for Translational Research in Inflammation - U 1286 Immunologie des Maladies Virales et Autoimmunes CHU Tenon [AP-HP] Centre Hospitalier Tourcoing Centre Hospitalier René Dubos [Pontoise] Assistance Publique - Hôpitaux de Marseille Santé Ingénierie Biologie Saint-Etienne Biologie Intégrative du Tissu Osseux Centre d'Investigation Clinique - Epidémiologie Clinique [CHU Saint-Etienne] Hôpital universitaire Robert Debré [Reims] CHU Pitié-Salpêtrière [AP-HP] Groupe Hospitalier Diaconesses Croix Saint-Simon Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy] Epidemiology in Dermatology and Evaluation in Therapeutics CHU Saint-Antoine [AP-HP] Centre Hospitalier Régional Universitaire [Montpellier] Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB) CHU Pitié-Salpêtrière [AP-HP] CHU Pitié-Salpêtrière [AP-HP] Hôpital Européen Georges Pompidou [APHP] Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] Biologie Intégrative du Tissu Osseux Centre Hospitalier Régional Universitaire [Lille] CHU Bordeaux [Bordeaux] Composantes innées de la réponse immunitaire et différenciation Laboratoire Chrono-environnement (UMR 6249) Centre Hospitalier Régional Universitaire de Besançon CHU Tenon [AP-HP] Maladies génétiques d'expression pédiatrique Centre Hospitalier Régional Universitaire [Montpellier] Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB) Centre Hospitalier Régional Universitaire [Montpellier] Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB) Centre Hospitalier Régional Universitaire [Montpellier]
• Publié dans The Lancet Rheumatology le 13/12/2019

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Résumé : Background: Various observations have suggested that the course of COVID-19 might be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases receiving rituximab compared with those not receiving rituximab. We aimed to investigate whether treatment with rituximab is associated with severe COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases.Methods: In this cohort study, we analysed data from the French RMD COVID-19 cohort, which included patients aged 18 years or older with inflammatory rheumatic and musculoskeletal diseases and highly suspected or confirmed COVID-19. The primary endpoint was the severity of COVID-19 in patients treated with rituximab (rituximab group) compared with patients who did not receive rituximab (no rituximab group). Severe disease was defined as that requiring admission to an intensive care unit or leading to death. Secondary objectives were to analyse deaths and duration of hospital stay. The inverse probability of treatment weighting propensity score method was used to adjust for potential confounding factors (age, sex, arterial hypertension, diabetes, smoking status, body-mass index, interstitial lung disease, cardiovascular diseases, cancer, corticosteroid use, chronic renal failure, and the underlying disease [rheumatoid arthritis vs others]). Odds ratios and hazard ratios and their 95% CIs were calculated as effect size, by dividing the two population mean differences by their SD. This study is registered with ClinicalTrials.gov, NCT04353609.Findings: Between April 15, 2020, and Nov 20, 2020, data were collected for 1090 patients (mean age 55·2 years [SD 16·4]); 734 (67%) were female and 356 (33%) were male. Of the 1090 patients, 137 (13%) developed severe COVID-19 and 89 (8%) died. After adjusting for potential confounding factors, severe disease was observed more frequently (effect size 3·26, 95% CI 1·66-6·40, p=0·0006) and the duration of hospital stay was markedly longer (0·62, 0·46-0·85, p=0·0024) in the 63 patients in the rituximab group than in the 1027 patients in the no rituximab group. 13 (21%) of 63 patients in the rituximab group died compared with 76 (7%) of 1027 patients in the no rituximab group, but the adjusted risk of death was not significantly increased in the rituximab group (effect size 1·32, 95% CI 0·55-3·19, p=0·53).Interpretation: Rituximab therapy is associated with more severe COVID-19. Rituximab will have to be prescribed with particular caution in patients with inflammatory rheumatic and musculoskeletal diseases.

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Fichiers liés : S266599132100059X.pdf

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