[Transition from pediatric to adult care: Recommendations of the French network for autoimmune and autoinflammatory diseases (FAI(2)R)].

Autoimmune and autoinflammatory diseases (AIDs) are a heterogeneous group of diseases. They can occur in childhood and account for significant morbidity and mortality. Transitioning from pediatric to adult healthcare can be difficult for patients and their families. It can interfere with patient follow-up and management, and eventually lead to complications. Although recommendations exist for the successful transition of patients with chronic diseases, few are specifically adapted to children and adults with AIDs (Suris et al., 2015-Solau-Gervais, 2012). The French working group on transition of the rare autoimmune and autoinflammatory diseases presents its reflections and recommendations for a successful transition. Preparation for transition should start early. Its goals are to empower adolescents by providing them with the knowledge to manage their own care, respond appropriately to changes in their condition, and evolve within the adult healthcare system. This requires the active participation of the patient, his or her family, as well as the pediatric and adult medical teams. The transition process involves multidisciplinary care and dedicated therapeutic education programs. Finally, the identification of medical specialists by region, trained in rare AIDs and accompanied by expert patients, may improve the management of patients with rare AIDs from adolescence to adulthood.

Georgin-Lavialle S ，Hentgen V ，Truchetet ME ，Romier M ，Hérasse M ，Maillard H ，Pha M ，Pillet P ，Reumaux H ，Duquesne A ，Larbre JP ，Belot A ... -  《-》

Transition from pediatric to adult care in adolescents with hereditary metabolic diseases: Specific guidelines from the French network for rare inherited metabolic diseases (G2M).

Inherited metabolic diseases (IMD) form a heterogeneous group of genetic disorders that surface primarily during childhood and result in significant morbidity and mortality. A prevalence of 1 in 2500-5000 live births is often reported. The transfer of adolescents from pediatric care to adult health facilities is often difficult for patients and their families and can lead to a breakdown in medical follow-up and therefore serious complications. Existing recommendations for the successful transition of patients with chronic disorders do not specifically address patients with IMDs associated with dietary treatment. Here, the French network for rare inherited metabolic diseases (G2M) presents its reflections and recommendations for a successful transition. Preparations for the transfer must be made well in advance. The transfer must aim for adolescents gaining autonomy by making them responsible and providing them with the knowledge that will enable them to manage their care themselves, know how to react appropriately if there is any change in their condition, and move comfortably within the adult healthcare system. This requires the active participation of the patient, his or her family, and pediatric and adult care teams. It involves multidisciplinary management plus the production and maintenance of an educational therapy program. Finally, the identification of physicians and dietitians trained in IMDs, relevant subspecialists, and even expert patients could improve the continuum of complete and appropriate care for these patients within adult medicine.

Chabrol B ，Jacquin P ，Francois L ，Broué P ，Dobbelaere D ，Douillard C ，Dubois S ，Feillet F ，Perrier A ，Fouilhoux A ，Labarthe F ，Lamireau D ，Mazodier K ，Maillot F ，Mochel F ，Schiff M ，Belmatoug N ... -  《-》

Transition to Adult Care in Autoinflammatory Diseases: A Cohort of 111 French Patients.

Transitioning from pediatric to adult care is a critical step for individuals with autoinflammatory diseases, requiring effective programs to ensure continuity of care and disease management. Despite various recommendations, the effectiveness of transition programs, particularly in monogenic autoinflammatory diseases, remains understudied. A single-center medical records review study was conducted at the French National Reference Center for Adult Autoinflammatory Diseases in Tenon Hospital from 2017 to 2023. All patients who had consulted for the first time between the ages of 15 and 30 years and had received care for an autoinflammatory disease during childhood were included. The patients were classified according to whether they had undergone a transition, defined as either no transition, simple transition (referral letter), or joint transition (pediatrician and adult physician consultation). One hundred eleven patients (median age, 18 years) were included. Patients who consulted without transition started adult follow-up and were followed up less regularly than those who underwent the transition process ( p < 0.001 and p = 0.028). In patients with familial Mediterranean fever, the absence of a formal transition was associated with poorer disease control at baseline ( p = 0.019). The type of transition did not impact disease control during follow-up. Participation in a transition program is associated with earlier and more regular follow-up in adulthood. Although transition type did not significantly impact disease control during follow-up in familial Mediterranean fever, the potential benefit of joint consultation extends beyond consultation frequency and disease outcomes, encompassing patient perspectives and self-management abilities. This study highlights the significance of collaborative transition programs in AIDs.

Elhani I ，Hentgen V ，Quartier P ，Bader-Meunier B ，Kone-Paut I ，Neven B ，Rossi L ，Faye A ，Meinzer U ，Melki I ，Grateau G ，Savey L ，Georgin-Lavialle S ... -  《-》

[The transitional care from pediatrics to adult medicine within the rare autoimmune and autoinflammatory diseases network].

The committee involved in transitional care within the French network on rare autoimmune and auto-inflammatory diseases has developed tools and published recommendations for the care during the transition of adolescents and young adults suffering from these chronic diseases which often demonstrate flares. As the challenge is the compliance to the continuation of care in the adult world, the therapeutic alliance between the young patient and his/her pediatrician and then his/her adult doctor is particularly important. The working group thus carried out a survey on how doctors and young patients perceive their relationship during the period of transition in medical supervision.

Herasse M ，Romier M ，Hentgen V ，Duquesne A ，Larbre JP ，Maillard H ，Pha M ，Pillet P ，Reumaux H ，Truchetet ME ，Georgin-Lavialle S ，Belot A ... -  《-》

Transition from paediatric to adult care in adolescents with neurological diseases and handicap.

The transfer of adolescents from paediatric care to adult health facilities is often difficult for the patients and their families and can lead to a breakdown in medical follow-up and therefore serious complications. Existing recommendations for the successful transition of patients with chronic disorders do not specifically address patients with handicap. Preparations for the transfer must be made well in advance. They must aim to achieve the autonomisation of adolescents by making them responsible and providing them with the knowledge that will enable them to manage their care themselves, the know-how to react appropriately if there is any change in their condition, and to move comfortably within the adult health system. This requires the active participation of the patient, his or her family and the paediatric and adult care teams. It involves multidisciplinary management plus the production and maintenance of an educational therapy programme. Finally, the identification of doctors trained in handicap, relevant sub-specialists and even expert patients could enable improvements in the continuum of complete and appropriate care for these patients within adult medicine.

Chabrol B ，Milh M 《-》