Early Systemic Sclerosis: Analysis of the Disease Course in Patients With Marker Autoantibody and/or Capillaroscopic Positivity. Issue 10 (October 2014)

• Record Type: Journal Article
• Authors: Valentini, Gabriele; Marcoccia, Antonella; Cuomo, Giovanna; Vettori, Serena; Iudici, Michele; Bondanini, Francesco; Santoriello, Carlo; Ciani, Aldo; Cozzolino, Domenico; De Matteis, Giovanni Maria; Cappabianca, Salvatore; Vitelli, Filiberto; Spanò, Alberto
• Is Part Of: Arthritis care & research. Volume 66:Issue 10(2014:Oct.)
• Page Start: 1520
• Page End: 1527
• Publication Date: 2014-10
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/acr.22304
• Languages: English
• ISSNs: 2151-464X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="acr22304-sec-0001" sec-type="section"> <title>Objective</title> <p>To investigate whether patients affected by 1 of the 3 subsets of early systemic sclerosis (SSc; scleroderma), i.e., subset I, Raynaud's phenomenon with SSc marker autoantibodies and typical capillaroscopic findings; subset II, autoantibody positive only; and subset III, capillaroscopy positive only and not satisfying the 2013 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for SSc at admission, differ from each other in the time to satisfy the criteria.</p> </sec> <sec id="acr22304-sec-0002" sec-type="section"> <title>Methods</title> <p>Early SSc patients subdivided into the 3 subsets indicated above consecutively admitted to a rheumatology/angiology center were monitored for 12–102 months (median 36 months). Patients were reevaluated twice yearly to assess whether and when each patient satisfied the new ACR/EULAR classification criteria for SSc. Patients with undifferentiated connective tissue disease (UCTD) served as the comparator group.</p> </sec> <sec id="acr22304-sec-0003" sec-type="section"> <title>Results</title> <p>During followup, 11 (52.3%) of 21 subset I, 10 (66.6%) of 15 subset II, 0 of 24 subset III, and 0 of 44 UCTD patients satisfied the criteria (<italic>P</italic> = 0.0001). The difference was significant between early SSc and UCTD patients (<italic>P</italic> = 0.0001) and, within the group of early SSc patients, between each of the 2 autoantibody‐positive subsets (subsets I and II) and the capillaroscopic‐positive/autoantibody‐negative subset (subset I versus III: <italic>P</italic> = 0.0001; subset II versus III: <italic>P</italic> = 0.0009). There was no difference between the 2 autoantibody‐positive subsets (<italic>P</italic> = 0.454). In addition to marker autoantibody positivity, preclinical lung or heart involvement was associated with an increased risk to satisfy the criteria during followup.</p> </sec> <sec id="acr22304-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Our data demonstrated faster progression of SSc in autoantibody‐positive patients, particularly in those with preclinical internal organ involvement at baseline, than in autoantibody‐negative patients.</p> </sec> </abstract>