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.

Joint and tendon involvement predict disease progression in systemic sclerosis: A EUSTAR prospective study / 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. - In: ANNALS OF THE RHEUMATIC DISEASES. - ISSN 0003-4967. - 75:(2016), pp. 103-109. [10.1136/annrheumdis-2014-205295]

Joint and tendon involvement predict disease progression in systemic sclerosis: A EUSTAR prospective study

Matucci Cerinic, Marco;
2016-01-01

Abstract

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.
2016
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
Immunology and Allergy
Rheumatology
Immunology
Medicine (all)
Biochemistry
Genetics and Molecular Biology (all)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/154255
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