Nailfold videocapillaroscopy patterns in systemic sclerosis : implications for cutaneous subsets, disease features and prognostic value for survival
OBJECTIVES: To assess the associations and prognostic value of scleroderma patterns by nailfold videocapillaroscopy (NVC) in patients with systemic sclerosis (SSc) and cutaneous subsets.
METHODS: At baseline, 1356 SSc patients from the RESCLE registry were compared according to the scleroderma pattern as Late pattern and non-Late pattern, which included Early and Active patterns. Patient characteristics, disease features, survival time and causes of death were analysed.
RESULTS: Late pattern was identified in 540 (39.8%), and non-Late pattern in 816 (60.2%) patients (88% women; 987 lcSSc/251 dcSSc). Late pattern was associated to dcSSc (OR=1.96; p<0.001), interstitial lung disease (ILD) (OR=1.29; p=0.031), and scleroderma renal crisis (OR=3.46; p<0.001). Once the cutaneous subset was disregarded in an alternative analysis, both digital ulcers (DU) (OR=1.29; p<0.037) and anti-topoisomerase I antibodies (OR=1.39; p< 0.036) emerged associated with the Late pattern. By cutaneous subsets, associations with Late pattern were: (1) in dcSSc, acro-osteolysis (OR=2.13; p=0.022), and systolic pulmonary artery pressure >40 mmHg by Doppler echocardiogram (OR=2.24; p<0.001); and (2) in lcSSc, ILD (OR=1.38; p=0.028). Survival was reduced in dcSSc with Late pattern compared to non-Late pattern (p=0.049). Risk factors for SSc mortality in multivariate regression Cox analysis were age at diagnosis (HR=1.03; p<0.001), dcSSc (HR=2.48; p<0.001), DU (HR=1.38; p=0.046), ILD (HR=2.81; p<0.001), and pulmonary arterial hypertension (HR=1.99; p<0.001).
CONCLUSIONS: SSc patients with Late pattern more frequently present dcSSc and develop more fibrotic and vascular manifestations. Advanced microangiopathy by NVC identifies dcSSc patients at risk of reduced survival due to SSc-related causes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
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| Enthalten in: |
Clinical and experimental rheumatology - 41(2023), 8 vom: 18. Aug., Seite 1695-1703 |
| Sprache: |
Englisch |
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Date Completed 04.08.2023 Date Revised 04.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.55563/clinexprheumatol/8lrofr |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM360346979 |
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| 100 | 1 | |a Tolosa-Vilella, Carles |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Nailfold videocapillaroscopy patterns in systemic sclerosis |b implications for cutaneous subsets, disease features and prognostic value for survival |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 04.08.2023 | ||
| 500 | |a Date Revised 04.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: To assess the associations and prognostic value of scleroderma patterns by nailfold videocapillaroscopy (NVC) in patients with systemic sclerosis (SSc) and cutaneous subsets | ||
| 520 | |a METHODS: At baseline, 1356 SSc patients from the RESCLE registry were compared according to the scleroderma pattern as Late pattern and non-Late pattern, which included Early and Active patterns. Patient characteristics, disease features, survival time and causes of death were analysed | ||
| 520 | |a RESULTS: Late pattern was identified in 540 (39.8%), and non-Late pattern in 816 (60.2%) patients (88% women; 987 lcSSc/251 dcSSc). Late pattern was associated to dcSSc (OR=1.96; p<0.001), interstitial lung disease (ILD) (OR=1.29; p=0.031), and scleroderma renal crisis (OR=3.46; p<0.001). Once the cutaneous subset was disregarded in an alternative analysis, both digital ulcers (DU) (OR=1.29; p<0.037) and anti-topoisomerase I antibodies (OR=1.39; p< 0.036) emerged associated with the Late pattern. By cutaneous subsets, associations with Late pattern were: (1) in dcSSc, acro-osteolysis (OR=2.13; p=0.022), and systolic pulmonary artery pressure >40 mmHg by Doppler echocardiogram (OR=2.24; p<0.001); and (2) in lcSSc, ILD (OR=1.38; p=0.028). Survival was reduced in dcSSc with Late pattern compared to non-Late pattern (p=0.049). Risk factors for SSc mortality in multivariate regression Cox analysis were age at diagnosis (HR=1.03; p<0.001), dcSSc (HR=2.48; p<0.001), DU (HR=1.38; p=0.046), ILD (HR=2.81; p<0.001), and pulmonary arterial hypertension (HR=1.99; p<0.001) | ||
| 520 | |a CONCLUSIONS: SSc patients with Late pattern more frequently present dcSSc and develop more fibrotic and vascular manifestations. Advanced microangiopathy by NVC identifies dcSSc patients at risk of reduced survival due to SSc-related causes | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Boldova-Aguar, Rafael |e verfasserin |4 aut | |
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| 700 | 1 | |a Freire, Mayka |e verfasserin |4 aut | |
| 700 | 1 | |a Vargas-Hitos, Jose Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Ríos-Blanco, Juan J |e verfasserin |4 aut | |
| 700 | 1 | |a Todolí-Parra, Jose Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez-Pintó, Ignasi |e verfasserin |4 aut | |
| 700 | 1 | |a Chamorro, Antonio-J |e verfasserin |4 aut | |
| 700 | 1 | |a Pla-Salas, Xavier |e verfasserin |4 aut | |
| 700 | 1 | |a Madroñero-Vuelta, Ana Belén |e verfasserin |4 aut | |
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