Digital ulcers predict a worse disease course in patients with systemic sclerosis

EUSTAR

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Objective: Systemic sclerosis (SSc) is a systemic autoimmune disease with high morbidity and significant mortality. There is a great need of predictors that would allow risk stratification of patients with SSc and ultimately initiation of treatment early enough to ensure optimal clinical results. In this study, we evaluated whether a history of digital ulcers (HDU) at presentation may be a predictor of vascular outcomes and of overall clinical worsening and death in patients with SSc. Methods: Patients from the EULAR Scleroderma Trials and Research (EUSTAR) database, satisfying at inclusion the 1980 American College of Rheumatology classification criteria for SSc, who had a follow-up of at least 3 years since baseline or who have died, were included in the analysis. HDU at presentation as a predictor of disease worsening or death was evaluated by Cox proportional hazards regression analysis. Results :3196 patients matched the inclusion criteria (male sex 13.2%, 33.4% diffuse subset). At presentation, 1092/3196 patients had an HDU (34.1%). In multivariable analysis adjusting for age, gender and all parameters considered potentially significant, HDU was predictive for the presence of active digital ulcers (DUs) at prospective visits (HR (95% CI)): 2.41(1.91 to 3.03), p

Original languageEnglish
Pages (from-to)681-686
Number of pages6
JournalAnnals of the Rheumatic Diseases
Volume75
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

Fingerprint

Systemic Scleroderma
Ulcer
Regression analysis
Hazards
Autoimmune Diseases
Blood Vessels
Regression Analysis
Databases
Morbidity
Mortality
Research

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

Cite this

Digital ulcers predict a worse disease course in patients with systemic sclerosis. / EUSTAR.

In: Annals of the Rheumatic Diseases, Vol. 75, No. 4, 01.04.2016, p. 681-686.

Research output: Contribution to journalArticle

@article{82fb63fa83334802a375b5eb6cb97dbb,
title = "Digital ulcers predict a worse disease course in patients with systemic sclerosis",
abstract = "Objective: Systemic sclerosis (SSc) is a systemic autoimmune disease with high morbidity and significant mortality. There is a great need of predictors that would allow risk stratification of patients with SSc and ultimately initiation of treatment early enough to ensure optimal clinical results. In this study, we evaluated whether a history of digital ulcers (HDU) at presentation may be a predictor of vascular outcomes and of overall clinical worsening and death in patients with SSc. Methods: Patients from the EULAR Scleroderma Trials and Research (EUSTAR) database, satisfying at inclusion the 1980 American College of Rheumatology classification criteria for SSc, who had a follow-up of at least 3 years since baseline or who have died, were included in the analysis. HDU at presentation as a predictor of disease worsening or death was evaluated by Cox proportional hazards regression analysis. Results :3196 patients matched the inclusion criteria (male sex 13.2{\%}, 33.4{\%} diffuse subset). At presentation, 1092/3196 patients had an HDU (34.1{\%}). In multivariable analysis adjusting for age, gender and all parameters considered potentially significant, HDU was predictive for the presence of active digital ulcers (DUs) at prospective visits (HR (95{\%} CI)): 2.41(1.91 to 3.03), p",
author = "EUSTAR and Carina Mihai and Robert Landew{\'e} and {Van Der Heijde}, D{\'e}sir{\'e}e and Walker, {Ulrich A.} and Constantin, {Paul I.} and Gherghe, {Ana Maria} and Ruxandra Ionescu and Simona Rednic and Yannick Allanore and J{\'e}roˆme Avouac and L. Czirj{\'a}k and Eric Hachulla and Gabriela Riemekasten and Franco Cozzi and Paolo Air{\`o} and Maurizio Cutolo and Ulf Mueller-Ladner and Marco Matucci-Cerinic and David Launay and Rucsandra Dobrota and Roxana Sfrent-Cornateanu and Stefania Zingarelli and Erika Pigatto and Giovanna Cuomo and Paola Caramaschi and Lidia Ananieva and Susanne Ullman and Line Iversen and Gurman, {Alexandra Balbir} and Yolanda Braun-Moscovici and Carreira, {Patricia E.} and Joven, {Beatriz E.} and T{\"u}nde Minier and Serena Guiducci and Silvia Bellando-Randone and Raffaele Pellerito and Nicolas Hunzelmann and Tarner, {Ingo H.} and Radominski, {Sebasti{\~a}o Cezar} and {De Souza M{\"u}ller}, Carolina and Florenzo Iannone and J{\"o}rg Henes and Bancel, {Dominique Farge} and Nemanja Damjanov and Predrag Ostojic and Pozzi, {Maria Rosa} and Roger Hesselstrand and Christopher Denton and Dorota Krasowska and Mohammed Tikly",
year = "2016",
month = "4",
day = "1",
doi = "10.1136/annrheumdis-2014-205897",
language = "English",
volume = "75",
pages = "681--686",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "BMJ Publishing Group",
number = "4",

}

TY - JOUR

T1 - Digital ulcers predict a worse disease course in patients with systemic sclerosis

AU - EUSTAR

AU - Mihai, Carina

AU - Landewé, Robert

AU - Van Der Heijde, Désirée

AU - Walker, Ulrich A.

AU - Constantin, Paul I.

AU - Gherghe, Ana Maria

AU - Ionescu, Ruxandra

AU - Rednic, Simona

AU - Allanore, Yannick

AU - Avouac, Jéroˆme

AU - Czirják, L.

AU - Hachulla, Eric

AU - Riemekasten, Gabriela

AU - Cozzi, Franco

AU - Airò, Paolo

AU - Cutolo, Maurizio

AU - Mueller-Ladner, Ulf

AU - Matucci-Cerinic, Marco

AU - Launay, David

AU - Dobrota, Rucsandra

AU - Sfrent-Cornateanu, Roxana

AU - Zingarelli, Stefania

AU - Pigatto, Erika

AU - Cuomo, Giovanna

AU - Caramaschi, Paola

AU - Ananieva, Lidia

AU - Ullman, Susanne

AU - Iversen, Line

AU - Gurman, Alexandra Balbir

AU - Braun-Moscovici, Yolanda

AU - Carreira, Patricia E.

AU - Joven, Beatriz E.

AU - Minier, Tünde

AU - Guiducci, Serena

AU - Bellando-Randone, Silvia

AU - Pellerito, Raffaele

AU - Hunzelmann, Nicolas

AU - Tarner, Ingo H.

AU - Radominski, Sebastião Cezar

AU - De Souza Müller, Carolina

AU - Iannone, Florenzo

AU - Henes, Jörg

AU - Bancel, Dominique Farge

AU - Damjanov, Nemanja

AU - Ostojic, Predrag

AU - Pozzi, Maria Rosa

AU - Hesselstrand, Roger

AU - Denton, Christopher

AU - Krasowska, Dorota

AU - Tikly, Mohammed

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Objective: Systemic sclerosis (SSc) is a systemic autoimmune disease with high morbidity and significant mortality. There is a great need of predictors that would allow risk stratification of patients with SSc and ultimately initiation of treatment early enough to ensure optimal clinical results. In this study, we evaluated whether a history of digital ulcers (HDU) at presentation may be a predictor of vascular outcomes and of overall clinical worsening and death in patients with SSc. Methods: Patients from the EULAR Scleroderma Trials and Research (EUSTAR) database, satisfying at inclusion the 1980 American College of Rheumatology classification criteria for SSc, who had a follow-up of at least 3 years since baseline or who have died, were included in the analysis. HDU at presentation as a predictor of disease worsening or death was evaluated by Cox proportional hazards regression analysis. Results :3196 patients matched the inclusion criteria (male sex 13.2%, 33.4% diffuse subset). At presentation, 1092/3196 patients had an HDU (34.1%). In multivariable analysis adjusting for age, gender and all parameters considered potentially significant, HDU was predictive for the presence of active digital ulcers (DUs) at prospective visits (HR (95% CI)): 2.41(1.91 to 3.03), p

AB - Objective: Systemic sclerosis (SSc) is a systemic autoimmune disease with high morbidity and significant mortality. There is a great need of predictors that would allow risk stratification of patients with SSc and ultimately initiation of treatment early enough to ensure optimal clinical results. In this study, we evaluated whether a history of digital ulcers (HDU) at presentation may be a predictor of vascular outcomes and of overall clinical worsening and death in patients with SSc. Methods: Patients from the EULAR Scleroderma Trials and Research (EUSTAR) database, satisfying at inclusion the 1980 American College of Rheumatology classification criteria for SSc, who had a follow-up of at least 3 years since baseline or who have died, were included in the analysis. HDU at presentation as a predictor of disease worsening or death was evaluated by Cox proportional hazards regression analysis. Results :3196 patients matched the inclusion criteria (male sex 13.2%, 33.4% diffuse subset). At presentation, 1092/3196 patients had an HDU (34.1%). In multivariable analysis adjusting for age, gender and all parameters considered potentially significant, HDU was predictive for the presence of active digital ulcers (DUs) at prospective visits (HR (95% CI)): 2.41(1.91 to 3.03), p

UR - http://www.scopus.com/inward/record.url?scp=84930163748&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930163748&partnerID=8YFLogxK

U2 - 10.1136/annrheumdis-2014-205897

DO - 10.1136/annrheumdis-2014-205897

M3 - Article

C2 - 25688073

AN - SCOPUS:84930163748

VL - 75

SP - 681

EP - 686

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 4

ER -