Hotel Dieu Hospital

BackgroundBiosimilars are increasingly used in rheumatology practice; however, knowledge gaps and regulatory uncertainties may affect their acceptance. This study assessed the knowledge, perceptions, and clinical practices related to biosimilars among rheumatologists in the Arab League of Associations for Rheumatology (ArLAR) countries.MethodsA web-based survey of 19 questions, adapted from a European Society for Medical Oncology (ESMO) tool, was distributed among ArLAR-affiliated rheumatologists between July 2024 and January 2025. The questionnaire assessed knowledge, attitudes, clinical use, and educational preferences. A French version was developed and validated by the study steering committee. Responses were analyzed using descriptive statistics.ResultsA total of 105 rheumatologists from various Arab countries participated in the survey. The mean age of participants was 43.6 ± 11.7 years, and 61.9% were females. Most participants were adult rheumatologists (94.3%), primarily from Iraq (37.1%), Morocco (19%), and Algeria (16.2%). While 85.7% reported using biosimilars in practice, only 50.5% correctly identified the formal definition. Comfort with EMA/FDA-approved biosimilars was high (mean score 4.22/5), while concerns remained about switching in stable patients and among multiple biosimilars. The majority (80%) expressed interest in additional biosimilar education, particularly on regulatory approval, extrapolation, and safety.ConclusionArLAR rheumatologists show high uptake of biosimilars but moderate understanding of key regulatory and clinical concepts. Regionally adapted educational programs are needed to support evidence-based biosimilar use and improve confidence in clinical decision-making.

We assessed long-term trends in cancer incidence among people with HIV (PWH) in France between 1997 and 2018, focusing on AIDS-defining cancers (ADC) (Kaposi's sarcoma, non-Hodgkin's lymphoma, and cervical cancer), three virus-related non-AIDS-defining cancers (Hodgkin lymphoma, liver, and anal cancer), and four virus-unrelated cancers (lung, colorectal, prostate, and breast cancer). Using data from the ANRS CO4-French Hospital Database on HIV and cancer registries in the general population, we calculated age-standardized incidence rates and standardized incidence ratios (SIRs) across four time periods. Special attention was given to PWH with controlled viral load and restored CD4 during 2008-2018. Among 154,733 individuals contributing nearly 2 million person-years, 9572 cancers were diagnosed. Incidence rates of ADC and virus-related non-ADC declined over time but remained significantly higher than in the general population, with SIRs ranging from 3 to 420, even in recent years. Rates of prostate and colorectal cancers increased overtime, while breast cancer incidence remained stable. For these three cancers, the relative risk compared to the general population remained close to 1. In PWH with CD4 ≥ 500/mm3 for at least 2 years and with recent viral load ≤50 copies/mL, risks of virus-related cancers (KS, NHL, HL, liver, and anal cancer) remained significantly higher relative to the general population, albeit to a lesser extent than in PWH overall, while risks of lung and cervical cancers were similar. Over 20 years, the incidence of all virus-related cancers continued to fall but in the most recent period, the risks still remained higher than in the general population.