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Hughes, Michael; Heal, Calvin; Henes, Jörg; Balbir-Gurman, Alexandra; Distler, Jörg H W; Airò, Paolo; Müller-Ladner, Ulf; Hunzelmann, Nicolas; Kerzberg, Eduardo; Rudnicka, Lidia; Truchetet, Marie-Elise; Stebbings, Simon; Tanaka, Yoshiya; Hoffman-Vold, Anna Maria; Gabrielli, Armando; Distler, Oliver; Matucci-Cerinic, Marco; Ananieva, Lidia P; de Vries-Bouwstra, Jeska; Bruni, Cosimo; Cantatore, Francesco Paolo; Castellví, Ivan; Cutolo, Maurizio; Damjanov, Nemanja; [...]

Digital pitting scars are associated with a severe disease course and death in systemic sclerosis: a study from the EUSTAR cohort

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  • Medientyp: E-Artikel
  • Titel: Digital pitting scars are associated with a severe disease course and death in systemic sclerosis: a study from the EUSTAR cohort
  • Beteiligte: Hughes, Michael; Heal, Calvin; Henes, Jörg; Balbir-Gurman, Alexandra; Distler, Jörg H W; Airò, Paolo; Müller-Ladner, Ulf; Hunzelmann, Nicolas; Kerzberg, Eduardo; Rudnicka, Lidia; Truchetet, Marie-Elise; Stebbings, Simon; Tanaka, Yoshiya; Hoffman-Vold, Anna Maria; Gabrielli, Armando; Distler, Oliver; Matucci-Cerinic, Marco; Ananieva, Lidia P; de Vries-Bouwstra, Jeska; Bruni, Cosimo; Cantatore, Francesco Paolo; Castellví, Ivan; Cutolo, Maurizio; Damjanov, Nemanja; [...]
  • Erschienen: Oxford University Press (OUP), 2022
  • Erschienen in: Rheumatology
  • Sprache: Englisch
  • DOI: 10.1093/rheumatology/keab510
  • ISSN: 1462-0324; 1462-0332
  • Schlagwörter: Pharmacology (medical) ; Rheumatology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objective</jats:title> <jats:p>Digital pitting scars (DPS) are frequent, but little studied in SSc to date.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>An analysis of SSc patients enrolled in the EUSTAR database. Primary objectives were to (i) examine DPS prevalence; (ii) examine whether DPS are associated with digital ulcers (DUs) and active digital ischaemia (DUs or gangrene); and (iii) describe other associations with DPS including internal organ complications. Secondary objectives were whether DPS are associated with (i) functional impairment; (ii) structural microvascular disease; and (iii) mortality. Descriptive statistics and parametric/non-parametric tests were used. Binary logistic regression was used to examine the association between DPS and DUs, active digital ischaemia and mortality.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 9671 patients were included with reported DPS at any time point (n = 4924) or ‘never’ DPS (n = 4747). The majority (86.9%) were female and mean age was 55.7 years. DPS were associated with longer disease and Raynaud’s duration (both P ≤ 0.001). DPS were associated with interstitial lung disease, pulmonary hypertension, conduction blocks, telangiectases, calcinosis (all P ≤ 0.001) and joint synovitis (P = 0.021). Patients were more likely to have more severe capillaroscopic abnormality and greater hand functional impairment. Multivariable logistic regression analyses showed that DPS were associated (odds ratio) with DUs: 22.03 (19.51–24.87), active digital ischaemia: 6.30 (5.34–7.42) and death: 1.86 (1.48–2.36).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>DPS are associated with a severe disease course including death. The impact of DPS on hand function and ischaemia is significant. The presence of DPS should alert the clinician to a poor prognosis and need to optimize the therapeutic strategy.</jats:p> </jats:sec>
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