Laura Ross1, Wendy Stevens2, Candice Rabusa2, Michelle Wilson2, Nava Ferdowsi1, Jennifer Walker3, Joanne Sahhar4, Gene-Siew Ngian4, Jane Zochling5, Janet Roddy6, Kathleen Tymms7, Gabor Major8, Gemma Strickland2, Susanna M Proudman9, Mandana Nikpour1. 1. Department of Medicine, The University of Melbourne at St Vincent's Hospital, and Department of Rheumatology, St Vincent's Hospital, Melbourne, Australia. 2. Department of Rheumatology, St Vincent's Hospital, Melbourne, Australia. 3. Rheumatology Unit, Flinders Medical Centre, Adelaide, Australia. 4. Department of Rheumatology, Department of Medicine, Monash Health & Monash University, Melbourne, Australia. 5. Rheumatology Tasmania, Hobart, Australia. 6. Department of Rheumatology, Fiona Stanley Hospital, Perth, Australia. 7. Department of Rheumatology, Canberra Hospital, Canberra, Australia. 8. Department of Rheumatology, John Hunter Hospital, Newcastle, Australia. 9. Rheumatology Unit, Royal Adelaide Hospital, Adelaide, and Discipline of Medicine, University of Adelaide, Australia.
Abstract
OBJECTIVES: The role of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in the assessment of disease activity in systemic sclerosis (SSc) remains controversial. We sought to evaluate the relationship between clinical features of SSc and raised inflammatory markers and to determine if changes in ESR and CRP reflect changes in other disease features over time. METHODS: One thousand, five hundred and forty-five patients enrolled in the Australian Scleroderma Cohort Study were observed over a mean 3.52±2.91 years and assessed at 6,119 study visits. Generalised estimating equations were used to determine the relationship between ESR≥20mm/hr and CRP≥5mg/L and features of disease. The associations between change in inflammatory markers and change in skin scores and respiratory function tests were analysed. RESULTS: Overall, there was a significant association between raised ESR and forced vital capacity (FVC)<80% predicted, diffusing capacity of the lung (DLCO)<80% predicted, pulmonary arterial hypertension (PAH), body mass index (BMI), proximal muscle strength, anaemia, and hypocomplementaemia (p<0.05). Raised CRP was significantly associated with modified Rodnan Skin Score>20, FVC<80%, DLCO<80%, PAH, digital ulcers, BMI, synovitis, tendon friction rub, anaemia, and hypocomplementaemia (p<0.05). A significant deterioration in respiratory function tests (RFTs) was associated with a 2-fold increase in both ESR and CRP (p<0.05). CONCLUSIONS: Raised inflammatory markers are associated with pulmonary, cutaneous and musculoskeletal manifestations of SSc. Rising inflammatory markers are correlated with declining respiratory function tests. This suggests inflammatory markers have a role in the assessment of SSc disease activity.
OBJECTIVES: The role of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in the assessment of disease activity in systemic sclerosis (SSc) remains controversial. We sought to evaluate the relationship between clinical features of SSc and raised inflammatory markers and to determine if changes in ESR and CRP reflect changes in other disease features over time. METHODS: One thousand, five hundred and forty-five patients enrolled in the Australian Scleroderma Cohort Study were observed over a mean 3.52±2.91 years and assessed at 6,119 study visits. Generalised estimating equations were used to determine the relationship between ESR≥20mm/hr and CRP≥5mg/L and features of disease. The associations between change in inflammatory markers and change in skin scores and respiratory function tests were analysed. RESULTS: Overall, there was a significant association between raised ESR and forced vital capacity (FVC)<80% predicted, diffusing capacity of the lung (DLCO)<80% predicted, pulmonary arterial hypertension (PAH), body mass index (BMI), proximal muscle strength, anaemia, and hypocomplementaemia (p<0.05). Raised CRP was significantly associated with modified Rodnan Skin Score>20, FVC<80%, DLCO<80%, PAH, digital ulcers, BMI, synovitis, tendon friction rub, anaemia, and hypocomplementaemia (p<0.05). A significant deterioration in respiratory function tests (RFTs) was associated with a 2-fold increase in both ESR and CRP (p<0.05). CONCLUSIONS: Raised inflammatory markers are associated with pulmonary, cutaneous and musculoskeletal manifestations of SSc. Rising inflammatory markers are correlated with declining respiratory function tests. This suggests inflammatory markers have a role in the assessment of SSc disease activity.
Authors: Mike Becker; Nicole Graf; Rafael Sauter; Yannick Allanore; John Curram; Christopher P Denton; Dinesh Khanna; Marco Matucci-Cerinic; Janethe de Oliveira Pena; Janet E Pope; Oliver Distler Journal: Ann Rheum Dis Date: 2019-06-21 Impact factor: 19.103
Authors: Oliver Distler; Shervin Assassi; Vincent Cottin; Maurizio Cutolo; Sonye K Danoff; Christopher P Denton; Jörg H W Distler; Anna-Maria Hoffmann-Vold; Sindhu R Johnson; Ulf Müller Ladner; Vanessa Smith; Elizabeth R Volkmann; Toby M Maher Journal: Eur Respir J Date: 2020-05-14 Impact factor: 16.671
Authors: Hyo Jin An; Kalthoum Tizaoui; Salvatore Terrazzino; Sarah Cargnin; Keum Hwa Lee; Seoung Wan Nam; Jae Seok Kim; Jae Won Yang; Jun Young Lee; Lee Smith; Ai Koyanagi; Louis Jacob; Han Li; Jae Il Shin; Andreas Kronbichler Journal: Int J Mol Sci Date: 2020-08-07 Impact factor: 5.923
Authors: Aleksey Mitev; Lisa Christ; Daria Feldmann; Moritz Binder; Kim Möller; Anna-Maria Kanne; Thomas Hügle; Peter M Villiger; Reinhard E Voll; Stephanie Finzel; Florian Kollert Journal: Arthritis Res Ther Date: 2019-12-02 Impact factor: 5.156
Authors: Zaneta Smolenska; Magdalena Zabielska-Kaczorowska; Anna Wojteczek; Barbara Kutryb-Zajac; Zbigniew Zdrojewski Journal: Front Mol Biosci Date: 2020-10-15