P E Carreira1, L Carmona2, B E Joven1, E Loza2, J L Andréu3, G Riemekasten4, S Vettori5, A Balbir-Gurman6, P Airò7, U Walker8, N Damjanov9, M Matucci-Cerinic10, L P Ananieva11, S Rednic12, L Czirják13, O Distler14, D Farge15, R Hesselstrand16, A Corrado17, P Caramaschi18, M Tikly19, Y Allanore20. 1. a Rheumatology Department , University Hospital 12 de Octubre , Madrid , Spain. 2. b Musculoskeletal Health Institute , Madrid , Spain. 3. c Rheumatology Department , University Hospital Puerta de Hierro , Madrid , Spain. 4. d Department of Rheumatology , University of Lübeck , Lübeck , Germany. 5. e Rheumatology Unit, Department of Internal Medicine Clinical and Experimental 'F Magrassi-A-Lanzara' , Second University of Naples , Naples , Italy. 6. f B Shine Rheumatology Unit , Rambam Health Care Campus and Rappaport Faculty of Medicine-Technion , Haifa , Israel. 7. g Rheumatology and Clinical Immunology Unit , Civil Hospitali , Brescia , Italy. 8. h Rheumatology Department , Felix Platter Hospital , Basel , Switzerland. 9. i University of Belgrade School of Medicine , Belgrade , Serbia. 10. j Division of Rheumatology, Department of Clinical and Experimental Medicine , University of Florence , Florence , Italy. 11. k Institute of Rheumatology , Russian Academy of Medical Science , Moscow , Russia. 12. l Rheumatology Clinic , University of Medicine and Pharmacy 'Iuliu Hatieganu' Cluj , Cluj-Napoca , Romania. 13. m Department of Immunology and Rheumatology, Faculty of Medicine , University of Pécs , Pécs , Hungary. 14. n Division of Rheumatology , University Hospital Zürich , Zürich , Switzerland. 15. o Department of Internal Medicine , Saint-Louis Hospital , Paris , France. 16. p Department of Rheumatology , Lund University Hospital , Lund , Sweden. 17. q Rheumatology Unit , University of Foggia, 'Col. D'Avanzo' Hospital , Foggia , Italy. 18. r Rheumatology Unit , AOUI , Verona , Italy. 19. s Rheumatology Unit, Department of Medicine , Chris Hani Baragwanath Hospital and University of the Witwatersrand , Johannesburg , South Africa. 20. t Rheumatology A Department , Cochin Hospital, APHP, Paris Descartes University , Paris , France.
Abstract
OBJECTIVE: The aim of this study was to analyse differences in clinical presentation in patients with early (< 3 years' duration) systemic sclerosis (SSc), comparing three age groups according to disease subsets. METHOD: Cross-sectional analysis of the prospective EULAR Scleroderma Trials and Research database (EUSTAR) was performed. Patients fulfilling preliminary American College of Rheumatology 1980 classification criteria for SSc, with < 3 years from the first non-Raynaud's SSc symptom at first entry, were selected. Patients with < 3 years from the first SSc symptom, including Raynaud's phenomenon, were also analysed. SSc-related variables, including antibodies, SSc subsets, and organ involvement, were examined. Age was categorized into ≤ 30, 31-59, and ≥ 60 years. We performed descriptive and bivariate analyses. RESULTS: The study included 1027 patients: 90% Caucasian, 80% women, and 40% with diffuse disease. In early stages of SSc, younger patients had significantly more anti-Scl-70 antibodies and diffuse disease. With increasing age, we observed more elevation of estimated pulmonary systolic pressure on echocardiography (5%, 13%, and 30%, respectively, in the three age groups), cardiac conduction blocks (6%, 6%, and 15%), and left ventricular diastolic dysfunction (4%, 12%, and 27%). The results were similar for 650 patients with < 3 years from first SSc symptom, including Raynaud's. CONCLUSION: In early stages of SSc, older patients showed data indicating more severe disease with greater cardiac involvement. The diffuse subset was more frequent in the younger subgroup. The identification of such differences may help in selecting appropriate management for individual patients in clinical practice.
OBJECTIVE: The aim of this study was to analyse differences in clinical presentation in patients with early (< 3 years' duration) systemic sclerosis (SSc), comparing three age groups according to disease subsets. METHOD: Cross-sectional analysis of the prospective EULAR Scleroderma Trials and Research database (EUSTAR) was performed. Patients fulfilling preliminary American College of Rheumatology 1980 classification criteria for SSc, with < 3 years from the first non-Raynaud's SSc symptom at first entry, were selected. Patients with < 3 years from the first SSc symptom, including Raynaud's phenomenon, were also analysed. SSc-related variables, including antibodies, SSc subsets, and organ involvement, were examined. Age was categorized into ≤ 30, 31-59, and ≥ 60 years. We performed descriptive and bivariate analyses. RESULTS: The study included 1027 patients: 90% Caucasian, 80% women, and 40% with diffuse disease. In early stages of SSc, younger patients had significantly more anti-Scl-70 antibodies and diffuse disease. With increasing age, we observed more elevation of estimated pulmonary systolic pressure on echocardiography (5%, 13%, and 30%, respectively, in the three age groups), cardiac conduction blocks (6%, 6%, and 15%), and left ventricular diastolic dysfunction (4%, 12%, and 27%). The results were similar for 650 patients with < 3 years from first SSc symptom, including Raynaud's. CONCLUSION: In early stages of SSc, older patients showed data indicating more severe disease with greater cardiac involvement. The diffuse subset was more frequent in the younger subgroup. The identification of such differences may help in selecting appropriate management for individual patients in clinical practice.
Authors: Cosimo Bruni; Maya H Buch; Daniel E Furst; Giacomo De Luca; Aleksandra Djokovic; Raluca B Dumitru; Alessandro Giollo; Marija Polovina; Alexia Steelandt; Kostantinos Bratis; Yossra Atef Suliman; Ivan Milinkovic; Anna Baritussio; Ghadeer Hasan; Anastasia Xintarakou; Yohei Isomura; George Markousis-Mavrogenis; Lorenzo Tofani; Sophie Mavrogeni; Luna Gargani; Alida Lp Caforio; Carsten Tschöpe; Arsen Ristic; Karin Klingel; Sven Plein; Elijah R Behr; Yannick Allanore; Masataka Kuwana; Christopher P Denton; Dinesh Khanna; Thomas Krieg; Renzo Marcolongo; Ilaria Galetti; Elisabetta Zanatta; Francesco Tona; Petar Seferovic; Marco Matucci-Cerinic Journal: J Scleroderma Relat Disord Date: 2021-10-26