Jérôme Avouac1, Gemma Lepri2, Vanessa Smith3, Elide Toniolo4, Charlotte Hurabielle4, Anaïs Vallet4, Fazia Amrouche4, André Kahan4, Maurizio Cutolo5, Yannick Allanore4. 1. Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France. Electronic address: jerome.avouac@cch.aphp.fr. 2. Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France; Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy. 3. Department of Rheumatology, Faculty of Internal Medicine, Ghent University Hospital, Ghent, Belgium. 4. Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France. 5. Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy.
Abstract
OBJECTIVE: To determine the merit of nailfold videocapillaroscopy (NVC) to detect meaningful microvascular changes over time in patients with systemic sclerosis (SSc) and whether these changes are associated with overall disease progression and organ involvements. METHODS: A prospective cohort of 140 SSc patients was recruited over a 12-month period and was followed up on an annual basis for 3 years. Detailed NVC analysis was performed at inclusion and repeated annually. Disease progression and organ damage were defined according to validated definitions. RESULTS: Significant NVC changes were detected in 72 SSc patients (51%) during the follow-up period. Patients with incident or increased number of giant capillaries were less at risk to develop new digital ulcers (DU) [hazard ratio (HR) = 0.53, 95% confidence interval (CI): 0.07-0.93]. Loss of capillaries over time was confirmed as a robust and independent marker of organ progression. The reduction of the number of capillaries was associated with overall disease progression (HR = 4.35, 95% CI: 1.87-10.12), occurrence of new DU (HR = 5.33, 95% CI: 1.69-16.71), lung vascular progression (HR = 18.53, 95% CI: 1.28-78.33), progression of skin fibrosis (HR = 4.22, 95% CI: 1.24-14.36), and worsening of the Medsger severity score (HR = 5.26, 95% CI: 1.78-15.52). CONCLUSION: Significant NVC changes are observed in almost half of the patients with SSc during a follow-up of 3 years. Sequential NVC examinations have responsiveness to detect disease progression. Sequential NVC is confirmed of value to monitor SSc, as well as progressive loss of capillaries over time as a potential surrogate marker for disease progression.
OBJECTIVE: To determine the merit of nailfold videocapillaroscopy (NVC) to detect meaningful microvascular changes over time in patients with systemic sclerosis (SSc) and whether these changes are associated with overall disease progression and organ involvements. METHODS: A prospective cohort of 140 SSc patients was recruited over a 12-month period and was followed up on an annual basis for 3 years. Detailed NVC analysis was performed at inclusion and repeated annually. Disease progression and organ damage were defined according to validated definitions. RESULTS: Significant NVC changes were detected in 72 SSc patients (51%) during the follow-up period. Patients with incident or increased number of giant capillaries were less at risk to develop new digital ulcers (DU) [hazard ratio (HR) = 0.53, 95% confidence interval (CI): 0.07-0.93]. Loss of capillaries over time was confirmed as a robust and independent marker of organ progression. The reduction of the number of capillaries was associated with overall disease progression (HR = 4.35, 95% CI: 1.87-10.12), occurrence of new DU (HR = 5.33, 95% CI: 1.69-16.71), lung vascular progression (HR = 18.53, 95% CI: 1.28-78.33), progression of skin fibrosis (HR = 4.22, 95% CI: 1.24-14.36), and worsening of the Medsger severity score (HR = 5.26, 95% CI: 1.78-15.52). CONCLUSION: Significant NVC changes are observed in almost half of the patients with SSc during a follow-up of 3 years. Sequential NVC examinations have responsiveness to detect disease progression. Sequential NVC is confirmed of value to monitor SSc, as well as progressive loss of capillaries over time as a potential surrogate marker for disease progression.
Authors: V Smith; M Cutolo; S Paolino; E Gotelli; F Goegan; A Casabella; G Ferrari; M Patane; M Albertelli; F Gatto; C Pizzorni; F Cattelan; A Sulli Journal: J Endocrinol Invest Date: 2020-05-24 Impact factor: 4.256
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Authors: Verônica Silva Vilela; Bruno Rangel Antunes da Silva; Cláudia Henrique da Costa; Agnaldo José Lopes; Roger Abramino Levy; Rogério Rufino Journal: BMC Res Notes Date: 2018-12-10
Authors: J Blagojevic; S Bellando-Randone; G Abignano; J Avouac; L Cometi; L Czirják; C P Denton; O Distler; M Frerix; S Guiducci; D Huscher; V K Jaeger; V Lóránd; B Maurer; S Nihtyanova; G Riemekasten; E Siegert; I H Tarner; S Vettori; U A Walker; Y Allanore; U Müller-Ladner; F Del Galdo; M Matucci-Cerinic Journal: Arthritis Res Ther Date: 2019-01-24 Impact factor: 5.156