Bar Le Duc

Researchers are evaluating the diagnostic use of two biomarkers, Glutathion S-Transferase-c0 (GST-c0) and Peroxyredoxin 1 (PRDX1), to identify patients who have experienced cerebral infarction (stroke) within a critical window of less than 4.5 hours. The study includes patients with neurological symptoms lasting less than 12 hours and aims to improve detection for timely treatment decisions, especially for those with unknown stroke onset times. Participants will have blood samples taken to measure GST-c0 and PRDX1 levels. These blood samples will be used for biological assessments and stored in a biobank. The study groups are defined by whether the blood sample is obtained within 4.5 hours or after 4.5 hours from stroke onset. Magnetic resonance imaging (MRI) must be performed within 30 minutes after blood collection to support diagnostic evaluation. During the study, participants will be evaluated for stroke symptoms and severity using the National Institute of Health Stroke Score. Researchers will collect detailed timing information about symptom onset and perform blood tests and MRI scans accordingly. The main outcomes measured are the time between stroke onset and blood sampling, assessing how well GST-c0 and PRDX1 levels identify strokes occurring within 4.5 hours. The study ensures participants are socially insured and monitors safety by excluding those with recent serious conditions or legal and psychiatric restrictions.

Researchers are investigating the best length of prednisone treatment to prevent relapses in patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA). These conditions can be controlled with immunosuppressive therapy, particularly with rituximab, but many patients experience recurring relapses that cause damage and require repeated treatments. While rituximab is used to maintain remission, the ideal duration of prednisone use remains unclear, with US studies favoring early withdrawal (6-12 months) and European studies supporting longer use (>18 months) due to lower relapse rates. Participants will be randomly assigned to receive either prednisone 5 mg/day orally for an additional 12 months with weekly tapering or a placebo after an initial tapering period. Both groups receive maintenance rituximab treatment. The study compares the effects of extended prednisone use versus early withdrawal on relapse rates to determine the best approach to maintenance therapy for these patients. During the study, participants will be monitored for relapse-free survival over 30 months, with relapse defined by a Birmingham Vasculitis Activity Score (BVAS) greater than zero. Researchers will track disease activity, medication adherence, and safety throughout the trial. The study includes assessments at screening and regular follow-up visits to evaluate the benefits and risks of prolonged prednisone treatment in combination with rituximab.