Universite Paris Est Creteil Val De Marne

The broad range of definitions of low back pain (LBP) and the many associated risk factors on which management strategies are based do not seem to be relevant for general practitioners.

Given the challenges of treating LBP and its impact on individuals' life, we aimed to explore the lived experiences of LBP patients to better understand their feelings, needs, and the internal and external resources they use for coping and treatment.

We used a comprehensive, qualitative, biographical approach to understand the patient's life events and the origins of these events in social life. First, each patient's life story was analysed individually to understand how they constructed their experiences. Then, a joint analysis identified common themes and overlapping patterns across different patient trajectories.

We identified two main action profiles. The first ('risk-taking') reflected a desire for personal independence, where patients struggled to change their habits despite experiencing pain. In the second profile ('quest for meaning'), painful experiences led patients to reflect on their lifestyle and self-functioning, prompting adjustments in their daily habits.

A comprehensive approach to understanding the patients' behaviour in relation to their LBP can improve care strategies. General practitioners should consider not only the physical symptoms but also the patient's social and personal context, including relationships, living environment, work activity, limitations, and guiding values.

Adult immunoglobulin A vasculitis (IgAV) course is variable, and its prognostic factors are poorly understood.

To identify risk factors for IgAV recurrence/relapse in adults.

We included adult patients with IgAV between January 2016 and July 2022. The primary outcome was the time to recurrence/relapse. Factors associated with recurrence/relapse were assessed with hazard ratios (HR) and 95% confidence intervals (CI). Treatment effectiveness was assessed using inverse probability of treatment weighting.

A total of 229 patients were included. Abdominal purpura and articular involvement were associated with a higher risk of recurrence/relapse (HR: 2.03 [95%CI: 1.16-3.58]; P = .014; HR: 2.29 [95%CI: 1.25-4.20]; P = .0074, respectively), as well as fever at diagnosis (HR: 3.54 [95%CI: 1.19-10.5]; P = .023]). Factors associated with lower risk were post-bacterial cause (HR: 0.26 [95%CI: 0.07-0.93]; P = .039) and systemic corticosteroids administration (HR: 0.30 [95%CI: 0.12-0.75]; P = .0098). In the inverse probability of treatment weighting analysis, corticosteroids were still associated with a reduced risk of recurrence/relapse (HR: 0.41 [95%CI: 0.18-0.93]; P = .03), whereas colchicine was not (HR: 0.84 [95%CI: 0.42-1.69]; P = .63).

Retrospective design.

Systemic corticosteroid administration and post-bacterial etiology appear to protect against recurrence/relapse in adult IgAV. Conversely, fever at diagnosis, abdominal purpura, and articular involvement may be associated with an increased risk.