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

Jérôme Avouac, Ulrich A. Walker, Eric Hachulla, Gabriela Riemekasten, Giovanna Cuomo, Patricia Carreira, Paola Caramaschi, Lidia P. Ananieva, Marco Matucci-Cerinic, Laszlo Czirjak, Christopher Denton, Ulf Müller Ladner, Yannick Allanore, Serena Guiducci, Alan Tyndall, Giovanni Lapadula, Florenzo Iannone, Oliver Distler, Radim Becvar, Stanislaw SierakowskyOtylia Kowal Bielecka, Maurizio Cutolo, Alberto Sulli, Gabriele Valentini, Simona Rednic, Ileana Nicoara, Panayiotis G. Vlachoyiannopoulos, Carlomaurizio Montecucco, Roberto Caporali, Srdan Novak, Carlo Chizzolini, Eugene J. Kucharz, Anna Kotulska, Franco Cozzi, Blaz Rozman, Carmel Mallia, Bernard Coleiro, Armando Gabrielli, Dominique Farge-Bancel, Sondess Hadj-Khelifa, Paolo Airo, Roger Hesselstrand, Agneta Scheja, Duska Martinovic, Alexandra Balbir Gurman, Yolanda Braun-Moscovici, Nicolas Hunzelmann, Raffaele Pellerito, Lisa Maria Bambara, Jadranka Morovic-Vergles, Carol Black, Nemanja Damjanov, Ina Kötter, Vera Ortiz Santamaria, Stefan Heitmann, Dorota Krasowska, Matthias Seidel, Paul Hasler, Harald Burkhardt, Andrea Himsel, José Antonio Pereira Da Silva, Maria João Salvador, Bojana Stamenkovi, Aleksandra Stankovic, Bianca Marasini, Laura Belloli, Mohammed Tikly, Lev N. Denisov, Raffaella Scorza, Merete Engelhart, Gitte Strauss, Gabriela Szucs, Szilvia Szamosi, Carlos De La Puente, Paloma García De La Peña Lefebvre, Øyvind Midtvedt, Torhild Garen, David Launay, G. Valesini, Valeria Riccieri, Ruxandra Maria Ionescu, Daniela Opris, Fredrick M. Wigley, Viktor Stoica, Carmen Marina Mihai, Jörg H W Distler, Pier Luigi Meroni, Silvana Zeni, Luc Mouthon, Vanessa Smith, F. Cantatore, Ada Corrado, Susanne Ullman, Line Iversen, Maria Rosa Pozzi, Kilian Eyerich, Rüdiger Hein, Jacek Szechinski, Piotr Wiland, Brigitte Krummel-Lorenz, Martin Aringer, Rene Westhovens, Ellen De Langhe, Branimir Anic, Marko Baresi, Maria Üprus, Kati Otsa, Sule Yavuz, Sebastião Cezar Radominski, Carolina De Souza Müller, Sergio Jimenez, Joanna Busquets, Sergei Popa, Svetlana Agachi, Thierry Zenone, Alessandro Mathieu, Alessandra Vacca, Lisa Stamp, Peter Chapman, Cristina Mihaela Tanaseanu, Monica Popescu, Rosario Foti, Silvia Rodriguez Rubio

Research output: Contribution to journalArticle

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

ASJC Scopus subject areas

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

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    Avouac, J., Walker, U. A., Hachulla, E., Riemekasten, G., Cuomo, G., Carreira, P., Caramaschi, P., Ananieva, L. P., Matucci-Cerinic, M., Czirjak, L., Denton, C., Ladner, U. M., Allanore, Y., Guiducci, S., Tyndall, A., Lapadula, G., Iannone, F., Distler, O., Becvar, R., ... Rubio, S. R. (2016). Joint and tendon involvement predict disease progression in systemic sclerosis: A EUSTAR prospective study. Annals of the Rheumatic Diseases, 75(1), 103-109. https://doi.org/10.1136/annrheumdis-2014-205295