Universität zu Köln

Hughes, Michael ORCID: 0000-0003-3361-4909, Heal, Calvin, Henes, Joerg, Balbir-Gurman, Alexandra, Distler, Jorg H. W., Airo, Paolo, Mueller-Ladner, Ulf, Hunzelmann, Nicolas, Kerzberg, Eduardo, Rudnicka, Lidia, Truchetet, Marie-Elise, Stebbings, Simon, Tanaka, Yoshiya, Hoffman-Vold, Anna Maria, Gabrielli, Armando, Distler, Oliver and Matucci-Cerinic, Marco (2022). Digital pitting scars are associated with a severe disease course and death in systemic sclerosis: a study from the EUSTAR cohort. RHEUMATOLOGY, 61 (3). S. 1141 - 1148. OXFORD: OXFORD UNIV PRESS. ISSN 1462-0332

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Abstract

Objective Digital pitting scars (DPS) are frequent, but little studied in SSc to date. Methods 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. Results 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). Conclusion 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hughes, Michael UNSPECIFIED orcid.org/0000-0003-3361-4909 UNSPECIFIED Heal, Calvin UNSPECIFIED UNSPECIFIED UNSPECIFIED Henes, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Balbir-Gurman, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Distler, Jorg H. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Airo, Paolo UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller-Ladner, Ulf UNSPECIFIED UNSPECIFIED UNSPECIFIED Hunzelmann, Nicolas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kerzberg, Eduardo UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudnicka, Lidia UNSPECIFIED UNSPECIFIED UNSPECIFIED Truchetet, Marie-Elise UNSPECIFIED UNSPECIFIED UNSPECIFIED Stebbings, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Tanaka, Yoshiya UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffman-Vold, Anna Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Gabrielli, Armando UNSPECIFIED UNSPECIFIED UNSPECIFIED Distler, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Matucci-Cerinic, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-605227
DOI:	10.1093/rheumatology/keab510
Journal or Publication Title:	RHEUMATOLOGY
Volume:	61
Number:	3
Page Range:	S. 1141 - 1148
Date:	2022
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1462-0332
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EULAR SCLERODERMA TRIALS; ULCERS; VASCULOPATHY Multiple languages Rheumatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60522