Joint and tendon involvement predict disease progression in systemic sclerosis: A EUSTAR prospective study
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AVOUAC, Jerome, POPA, Serghei, AGACHI, Svetlana. Joint and tendon involvement predict disease progression in systemic sclerosis: A EUSTAR prospective study. In: Annals of the Rheumatic Diseases, 2016, vol. 75, pp. 103-109. ISSN -. DOI: https://doi.org/10.1136/annrheumdis-2014-205295
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Annals of the Rheumatic Diseases
Volumul 75 / 2016 / ISSN - /ISSNe 0003-4967

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

DOI: https://doi.org/10.1136/annrheumdis-2014-205295

Pag. 103-109

Avouac Jerome1, Popa Serghei2, Agachi Svetlana2
 
1 Paris Descartes University,
2 ”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
Disponibil în IBN: 24 aprilie 2019


Rezumat

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.

Cuvinte-cheie
corticosteroid, immunosuppressive agent, methotrexate, antibody, DNA topoisomerase, TOP1 protein, human