Jérôme Avouac1, Ulrich A Walker2, Eric Hachulla3, Gabriela Riemekasten4, Giovanna Cuomo5, Patricia E Carreira6, Paola Caramaschi7, Lidia P Ananieva8, Marco Matucci-Cerinic9, Laszlo Czirjak10, Christopher Denton11, Ulf Müller Ladner12, Yannick Allanore1. 1. Rheumatology A Department, Paris Descartes University, Cochin Hospital, Paris, France. 2. Department of Rheumatology, Basel University, Basel, Switzerland. 3. Department of Internal Medicine, Université Lille Nord de France, IMPRT IFR 114, Hôpital Claude-Huriez, and Centre Hospitalier Régional Universitaire de Lille, Lille, France. 4. Department of Rheumatology, Clinical Immunology, German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine, Berlin, Germany. 5. Rheumatology Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy. 6. Rheumatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain. 7. Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italia. 8. Institute of Rheumatology, Russian Academy of Medical Science, Moscow, Russia. 9. Section of Rheumatology, Department of Medicine, University of Florence, Florence, Italy. 10. Department of Rheumatology and Immunology, University of Pecs, Pecs, Hungary. 11. Centre for Rheumatology, Royal Free and University College London Medical School, London, UK. 12. Department of Internal Medicine and Rheumatology, Justus-Liebig-University of Giessen, Kerckhoff-Klinik, Bad Nauheim, Germany.
Abstract
OBJECTIVE: To determine whether joint synovitis and tendon friction rubs (TFRs) can predict the progression of systemic sclerosis (SSc) over time. PATIENTS AND METHODS: We performed a prospective cohort study that included 1301 patients with SSc from the EUSTAR database with disease duration ≤3 years at inclusion and with a follow-up of at least 2 years. Presence or absence at clinical examination of synovitis and TFRs was extracted at baseline. Outcomes were skin, cardiovascular, renal and lung progression. Overall disease progression was defined according to the occurrence of at least one organ progression. RESULTS: Joint synovitis (HR: 1.26, 95% CI 1.01 to 1.59) and TFRs (HR: 1.32, 95% CI 1.03 to 1.70) were independently predictive of overall disease progression, as were also the diffuse cutaneous subset (HR: 1.30, 95% CI 1.05 to 1.61) and positive antitopoisomerase-I antibodies (HR: 1.25, 95% CI 1.02 to 1.53). Regarding skin progression, joint synovitis (HR: 1.67, 95% CI 1.06 to 2.64) and TFRs (HR: 1.69, 95% CI 1.02 to 2.77) were also independently predictive of worsening of the modified Rodnan skin score. For cardiovascular progression, joint synovitis was predictive of the occurrence of new digital ulcer(s) (HR: 1.45, 95% CI 1.08 to 1.96) and decreased left ventricular ejection fraction (HR: 2.20, 95% CI 1.06 to 4.57); TFRs were confirmed to be an independent predictor of scleroderma renal crisis (HR: 2.33, 95% CI 1.03 to 6.19). CONCLUSIONS: Joint synovitis and TFRs are independent predictive factors for disease progression in patients with early SSc. These easily detected clinical markers may be useful for the risk stratification of patients with SSc. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
OBJECTIVE: To determine whether joint synovitis and tendon friction rubs (TFRs) can predict the progression of systemic sclerosis (SSc) over time. PATIENTS AND METHODS: We performed a prospective cohort study that included 1301 patients with SSc from the EUSTAR database with disease duration ≤3 years at inclusion and with a follow-up of at least 2 years. Presence or absence at clinical examination of synovitis and TFRs was extracted at baseline. Outcomes were skin, cardiovascular, renal and lung progression. Overall disease progression was defined according to the occurrence of at least one organ progression. RESULTS:Joint synovitis (HR: 1.26, 95% CI 1.01 to 1.59) and TFRs (HR: 1.32, 95% CI 1.03 to 1.70) were independently predictive of overall disease progression, as were also the diffuse cutaneous subset (HR: 1.30, 95% CI 1.05 to 1.61) and positive antitopoisomerase-I antibodies (HR: 1.25, 95% CI 1.02 to 1.53). Regarding skin progression, joint synovitis (HR: 1.67, 95% CI 1.06 to 2.64) and TFRs (HR: 1.69, 95% CI 1.02 to 2.77) were also independently predictive of worsening of the modified Rodnan skin score. For cardiovascular progression, joint synovitis was predictive of the occurrence of new digital ulcer(s) (HR: 1.45, 95% CI 1.08 to 1.96) and decreased left ventricular ejection fraction (HR: 2.20, 95% CI 1.06 to 4.57); TFRs were confirmed to be an independent predictor of scleroderma renal crisis (HR: 2.33, 95% CI 1.03 to 6.19). CONCLUSIONS:Joint synovitis and TFRs are independent predictive factors for disease progression in patients with early SSc. These easily detected clinical markers may be useful for the risk stratification of patients with SSc. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Thasia G Woodworth; Yossra A Suliman; Wendi Li; Daniel E Furst; Philip Clements Journal: Nat Rev Nephrol Date: 2016-09-19 Impact factor: 28.314
Authors: Wieneke Mt van den Hombergh; Hanneke Ka Knaapen-Hans; Frank Hj van den Hoogen; Patricia Carreira; Oliver Distler; Roger Hesselstrand; Nicolas Hunzelmann; Serena Vettori; Jaap Fransen; Madelon C Vonk Journal: J Scleroderma Relat Disord Date: 2019-09-06
Authors: Murray Baron; Bashar Kahaleh; Elana J Bernstein; Lorinda Chung; Philip J Clements; Christopher Denton; Robyn T Domsic; Nava Ferdowsi; Ivan Foeldvari; Tracy Frech; Jessica K Gordon; Marie Hudson; Sindhu R Johnson; Dinesh Khanna; Zsuzsannah McMahan; Peter A Merkel; Sonali Narain; Mandana Nikpour; John D Pauling; Laura Ross; Antonia Maria Valenzuela Vergara; Alessandra Vacca Journal: J Scleroderma Relat Disord Date: 2018-07-18