Joint and tendon involvement predict disease progression in systemic sclerosis: A EUSTAR prospective study
Articolo
Data di Pubblicazione:
2016
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
Tipologia CRIS:
1.1 Articolo in rivista
Keywords:
Outcomes research; Synovitis; Systemic Sclerosis; Adult; Aged; Antibodies; DNA Topoisomerases, Type I; Disease Progression; Female; Follow-Up Studies; Friction; Humans; Kidney Diseases; Lung Diseases, Interstitial; Male; Middle Aged; Muscle Weakness; Predictive Value of Tests; Prospective Studies; Pulmonary Fibrosis; Scleroderma, Systemic; Skin Ulcer; Synovitis; Tendons; Ventricular Dysfunction, Left; Rheumatology; Immunology; Biochemistry, Genetics and Molecular Biology (all); Immunology and Allergy
Elenco autori:
Avouac, Jérôme; Walker, Ulrich A.; Hachulla, Eric; Riemekasten, Gabriela; Cuomo, Giovanna; Carreira, Patricia E.; Caramaschi, Paola; Ananieva, Lidia P.; Matucci Cerinic, Marco; Czirjak, Laszlo; Denton, Christopher; Ladner, Ulf Müller; Allanore, Yannick; Guiducci, Serena; Tyndall, Alan; Lapadula, Giovanni; Iannone, Florenzo; Distler, Oliver; Becvar, Radim; Sierakowsky, Stanislaw; Bielecka, Otylia Kowal; Cutolo, Maurizio; Sulli, Alberto; Valentini, Gabriele; Rednic, Simona; Nicoara, Ileana; Vlachoyiannopoulos, Panayiotis G.; Montecucco, Carlomaurizio; Caporali, Roberto; Novak, Srdan; Chizzolini, Carlo; Kucharz, Eugene J.; Kotulska, Anna; Cozzi, Franco; Rozman, Blaz; Mallia, Carmel; Coleiro, Bernard; Gabrielli, Armando; Farge Bancel, Dominique; Hadj Khelifa, Sondess; Airò, Paolo; Hesselstrand, Roger; Scheja, Agneta; Martinovic, Duska; Gurman, Alexandra Balbir; Braun Moscovici, Yolanda; Hunzelmann, Nicolas; Pellerito, Raffaele; Bambara, Lisa Maria; Morovic Vergles, Jadranka; Black, Carol; Damjanov, Nemanja; Kötter, Ina; Santamaria, Vera Ortiz; Heitmann, Stefan; Krasowska, Dorota; Seidel, Matthias; Hasler, Paul; Burkhardt, Harald; Himsel, Andrea; Da Silva, José Antonio Pereira; Salvador, Maria João; Stamenkovi, Bojana; Stankovic, Aleksandra; Marasini, Bianca; Belloli, Laura; Tikly, Mohammed; Denisov, Lev N.; Scorza, Raffaella; Engelhart, Merete; Strauss, Gitte; Szücs, Gabriella; Szamosi, Szilvia; De La Puente, Carlos; De La Peña Lefebvre, Paloma García; Midtvedt, Øyvind; Garen, Torhild; Launay, David; Valesini, Guido; Riccieri, Valeria; Ionescu, Ruxandra Maria; Opris, Daniela; Wigley, Fredrick M.; Stoica, Viktor; Mihai, Carmen Marina; Distler, Jörg; Meroni, Pierluigi; Zeni, Silvana; Mouthon, Luc; Smith, Vanessa; Cantatore, Francesco Paolo; Corrado, Ada; Ullman, Susanne; Iversen, Line; Pozzi, Maria Rosa; Eyerich, Kilian; Hein, Rüdiger; Szechinski, Jacek; Wiland, Piotr; Krummel Lorenz, Brigitte; Aringer, Martin; Westhovens, Rene; De Langhe, Ellen; Anic, Branimir; Baresi, Marko; Üprus, Maria; Otsa, Kati; Yavuz, Sule; Radominski, Sebastião Cezar; De Souza Müller, Carolina; Jimenez, Sergio; Busquets, Joanna; Popa, Sergei; Agachi, Svetlana; Zenone, Thierry; Mathieu, Alessandro; Vacca, Alessandra; Stamp, Lisa; Chapman, Peter; Tanaseanu, Cristina Mihaela; Popescu, Monica; Foti, Rosario; Rubio, Silvia Rodriguez
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