TY - JOUR
T1 - Nailfold capillaroscopy in SSc
T2 - innocent bystander or promising biomarker for novel severe organ involvement/progression?
AU - Vanhaecke, Amber
AU - Cutolo, Maurizio
AU - Distler, Oliver
AU - Riccieri, Valeria
AU - Allanore, Yannick
AU - Denton, Christopher P
AU - Hachulla, Eric
AU - Ingegnoli, Francesca
AU - Deschepper, Ellen
AU - Avouac, Jérôme
AU - Jordan, Suzana
AU - Launay, David
AU - Melsens, Karin
AU - Pizzorni, Carmen
AU - Sulli, Alberto
AU - Vasile, Massimiliano
AU - Herrick, Ariane L
AU - Smith, Vanessa
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology.
PY - 2022/11/2
Y1 - 2022/11/2
N2 - OBJECTIVES: Nailfold videocapillaroscopy (NVC) plays a well-established role in differentiating primary from secondary RP due to SSc. However, the association of NVC with novel severe organ involvement/progression in SSc has never been evaluated in a multicentre, multinational study, which we now perform for the first time.METHODS: Follow-up data from 334 SSc patients [265 women; 18 limited SSc (lSSc)/203 lcSSc/113 dcSSc] registered between November 2008 and January 2016 by seven tertiary centres in the EUSTAR-database, were analysed. Novel severe organ involvement/progression was defined as new/progressive involvement of the peripheral vasculature, lungs, heart, skin, gastrointestinal tract, kidneys, musculoskeletal system, or death, at the 12- or 24-month follow-up. NVC images at enrolment were quantitatively and qualitatively evaluated according to the standardized definitions of the EULAR Study Group on Microcirculation in Rheumatic Diseases. Uni- and multivariable logistic regression modelling (ULR, MLR) was performed.RESULTS: Of the 334 included SSc patients, 257 (76.9%) developed novel overall severe organ involvement/progression. Following MLR, normal capillary density was associated with less-frequent novel overall severe organ involvement/progression [odds ratio (OR) = 0.77, P < 0.001] and novel peripheral vascular involvement (OR = 0.79, P = 0.043); microhaemorrhages were associated with less novel pulmonary hypertension (OR = 0.47, P = 0.029); and a 'severe' (active/late) NVC pattern was associated with novel overall severe organ involvement/progression (OR = 2.14, P = 0.002) and skin progression (OR = 1.70, P = 0.049).CONCLUSIONS: Our results suggest that NVC may be a promising biomarker in SSc, certainly warranting further investigation. Despite the participation of tertiary centres, which follow their patients in a standardized way, we were underpowered to detect associations with infrequent severe organ involvement/progression.
AB - OBJECTIVES: Nailfold videocapillaroscopy (NVC) plays a well-established role in differentiating primary from secondary RP due to SSc. However, the association of NVC with novel severe organ involvement/progression in SSc has never been evaluated in a multicentre, multinational study, which we now perform for the first time.METHODS: Follow-up data from 334 SSc patients [265 women; 18 limited SSc (lSSc)/203 lcSSc/113 dcSSc] registered between November 2008 and January 2016 by seven tertiary centres in the EUSTAR-database, were analysed. Novel severe organ involvement/progression was defined as new/progressive involvement of the peripheral vasculature, lungs, heart, skin, gastrointestinal tract, kidneys, musculoskeletal system, or death, at the 12- or 24-month follow-up. NVC images at enrolment were quantitatively and qualitatively evaluated according to the standardized definitions of the EULAR Study Group on Microcirculation in Rheumatic Diseases. Uni- and multivariable logistic regression modelling (ULR, MLR) was performed.RESULTS: Of the 334 included SSc patients, 257 (76.9%) developed novel overall severe organ involvement/progression. Following MLR, normal capillary density was associated with less-frequent novel overall severe organ involvement/progression [odds ratio (OR) = 0.77, P < 0.001] and novel peripheral vascular involvement (OR = 0.79, P = 0.043); microhaemorrhages were associated with less novel pulmonary hypertension (OR = 0.47, P = 0.029); and a 'severe' (active/late) NVC pattern was associated with novel overall severe organ involvement/progression (OR = 2.14, P = 0.002) and skin progression (OR = 1.70, P = 0.049).CONCLUSIONS: Our results suggest that NVC may be a promising biomarker in SSc, certainly warranting further investigation. Despite the participation of tertiary centres, which follow their patients in a standardized way, we were underpowered to detect associations with infrequent severe organ involvement/progression.
KW - Humans
KW - Female
KW - Microscopic Angioscopy/methods
KW - Nails/blood supply
KW - Capillaries
KW - Scleroderma, Diffuse
KW - Biomarkers
KW - Scleroderma, Systemic
UR - http://www.scopus.com/inward/record.url?scp=85133953361&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/keac079
DO - 10.1093/rheumatology/keac079
M3 - Article
C2 - 35176132
SN - 1462-0324
VL - 61
SP - 4384
EP - 4396
JO - Rheumatology (Oxford, England)
JF - Rheumatology (Oxford, England)
IS - 11
ER -