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

EUSTAR collaborators

Research output: Contribution to journalArticle

45 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)103-109
Number of pages7
JournalAnnals of the Rheumatic Diseases
Volume75
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

Fingerprint

Synovitis
Friction
Systemic Scleroderma
Tendons
Disease Progression
Joints
Prospective Studies
Skin
Kidney
Stroke Volume
Ulcer
Cohort Studies
Biomarkers
Databases
Lung
Antibodies

ASJC Scopus subject areas

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

Cite this

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

In: Annals of the Rheumatic Diseases, Vol. 75, No. 1, 01.01.2016, p. 103-109.

Research output: Contribution to journalArticle

@article{52687a4c363e41b7bcb1968172a0c99f,
title = "Joint and tendon involvement predict disease progression in systemic sclerosis: A EUSTAR prospective study",
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.",
author = "{EUSTAR collaborators} and J{\'e}r{\^o}me Avouac and Walker, {Ulrich A.} and Eric Hachulla and Gabriela Riemekasten and Giovanna Cuomo and Carreira, {Patricia E.} and Paola Caramaschi and Ananieva, {Lidia P.} and Marco Matucci-Cerinic and Laszlo Czirjak and Christopher Denton and Ladner, {Ulf M{\"u}ller} and Yannick Allanore and Serena Guiducci and Alan Tyndall and Giovanni Lapadula and Florenzo Iannone and Oliver Distler and Radim Becvar and Stanislaw Sierakowsky and Bielecka, {Otylia Kowal} and Maurizio Cutolo and Alberto Sulli and Gabriele Valentini and Simona Rednic and Ileana Nicoara and Vlachoyiannopoulos, {Panayiotis G.} and Carlomaurizio Montecucco and Roberto Caporali and Srdan Novak and Carlo Chizzolini and Kucharz, {Eugene J.} and Anna Kotulska and Franco Cozzi and Blaz Rozman and Carmel Mallia and Bernard Coleiro and Armando Gabrielli and Dominique Farge-Bancel and Sondess Hadj-Khelifa and Paolo Air{\`o} and Roger Hesselstrand and Agneta Scheja and Duska Martinovic and Gurman, {Alexandra Balbir} and Yolanda Braun-Moscovici and Nicolas Hunzelmann and Raffaele Pellerito and Bambara, {Lisa Maria} and Jadranka Morovic-Vergles",
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TY - JOUR

T1 - Joint and tendon involvement predict disease progression in systemic sclerosis

T2 - A EUSTAR prospective study

AU - EUSTAR collaborators

AU - Avouac, Jérôme

AU - Walker, Ulrich A.

AU - Hachulla, Eric

AU - Riemekasten, Gabriela

AU - Cuomo, Giovanna

AU - Carreira, Patricia E.

AU - Caramaschi, Paola

AU - Ananieva, Lidia P.

AU - Matucci-Cerinic, Marco

AU - Czirjak, Laszlo

AU - Denton, Christopher

AU - Ladner, Ulf Müller

AU - Allanore, Yannick

AU - Guiducci, Serena

AU - Tyndall, Alan

AU - Lapadula, Giovanni

AU - Iannone, Florenzo

AU - Distler, Oliver

AU - Becvar, Radim

AU - Sierakowsky, Stanislaw

AU - Bielecka, Otylia Kowal

AU - Cutolo, Maurizio

AU - Sulli, Alberto

AU - Valentini, Gabriele

AU - Rednic, Simona

AU - Nicoara, Ileana

AU - Vlachoyiannopoulos, Panayiotis G.

AU - Montecucco, Carlomaurizio

AU - Caporali, Roberto

AU - Novak, Srdan

AU - Chizzolini, Carlo

AU - Kucharz, Eugene J.

AU - Kotulska, Anna

AU - Cozzi, Franco

AU - Rozman, Blaz

AU - Mallia, Carmel

AU - Coleiro, Bernard

AU - Gabrielli, Armando

AU - Farge-Bancel, Dominique

AU - Hadj-Khelifa, Sondess

AU - Airò, Paolo

AU - Hesselstrand, Roger

AU - Scheja, Agneta

AU - Martinovic, Duska

AU - Gurman, Alexandra Balbir

AU - Braun-Moscovici, Yolanda

AU - Hunzelmann, Nicolas

AU - Pellerito, Raffaele

AU - Bambara, Lisa Maria

AU - Morovic-Vergles, Jadranka

PY - 2016/1/1

Y1 - 2016/1/1

N2 - 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.

AB - 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.

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DO - 10.1136/annrheumdis-2014-205295

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JO - Annals of the Rheumatic Diseases

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