Prediction of improvement in skin fibrosis in diffuse cutaneous systemic sclerosis: a EUSTAR analysis

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Prediction of improvement in skin fibrosis in diffuse cutaneous systemic sclerosis: a EUSTAR analysis. / Dobrota, Rucsandra; Maurer, Brita; Graf, N; Jordan, S.; Mihai, Carina; Kowal-Bielecka, Otylia; Allanore, Yannick; Distler, Oliver; EUSTAR coauthors.

I: Annals of the Rheumatic Diseases, Vol. 75, Nr. 10, 25.03.2016, s. 1743-48.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Harvard

Dobrota, R, Maurer, B, Graf, N, Jordan, S, Mihai, C, Kowal-Bielecka, O, Allanore, Y, Distler, O & EUSTAR coauthors 2016, 'Prediction of improvement in skin fibrosis in diffuse cutaneous systemic sclerosis: a EUSTAR analysis', Annals of the Rheumatic Diseases, vol. 75, nr. 10, s. 1743-48. https://doi.org/10.1136/annrheumdis-2015-208024

APA

Dobrota, R., Maurer, B., Graf, N., Jordan, S., Mihai, C., Kowal-Bielecka, O., ... EUSTAR coauthors (2016). Prediction of improvement in skin fibrosis in diffuse cutaneous systemic sclerosis: a EUSTAR analysis. Annals of the Rheumatic Diseases, 75(10), 1743-48. https://doi.org/10.1136/annrheumdis-2015-208024

CBE

Dobrota R, Maurer B, Graf N, Jordan S, Mihai C, Kowal-Bielecka O, Allanore Y, Distler O, EUSTAR coauthors. 2016. Prediction of improvement in skin fibrosis in diffuse cutaneous systemic sclerosis: a EUSTAR analysis. Annals of the Rheumatic Diseases. 75(10):1743-48. https://doi.org/10.1136/annrheumdis-2015-208024

MLA

Vancouver

Author

Dobrota, Rucsandra ; Maurer, Brita ; Graf, N ; Jordan, S. ; Mihai, Carina ; Kowal-Bielecka, Otylia ; Allanore, Yannick ; Distler, Oliver ; EUSTAR coauthors. / Prediction of improvement in skin fibrosis in diffuse cutaneous systemic sclerosis: a EUSTAR analysis. I: Annals of the Rheumatic Diseases. 2016 ; Vol. 75, Nr. 10. s. 1743-48.

RIS

TY - JOUR

T1 - Prediction of improvement in skin fibrosis in diffuse cutaneous systemic sclerosis: a EUSTAR analysis

AU - Dobrota, Rucsandra

AU - Maurer, Brita

AU - Graf, N

AU - Jordan, S.

AU - Mihai, Carina

AU - Kowal-Bielecka, Otylia

AU - Allanore, Yannick

AU - Distler, Oliver

AU - EUSTAR coauthors

AU - Andréasson, Kristofer

PY - 2016/3/25

Y1 - 2016/3/25

N2 - OBJECTIVES: Improvement of skin fibrosis is part of the natural course of diffuse cutaneous systemic sclerosis (dcSSc). Recognising those patients most likely to improve could help tailoring clinical management and cohort enrichment for clinical trials. In this study, we aimed to identify predictors for improvement of skin fibrosis in patients with dcSSc. METHODS: We performed a longitudinal analysis of the European Scleroderma Trials And Research (EUSTAR) registry including patients with dcSSc, fulfilling American College of Rheumatology criteria, baseline modified Rodnan skin score (mRSS) ≥7 and follow-up mRSS at 12±2 months. The primary outcome was skin improvement (decrease in mRSS of >5 points and ≥25%) at 1 year follow-up. A respective increase in mRSS was considered progression. Candidate predictors for skin improvement were selected by expert opinion and logistic regression with bootstrap validation was applied. RESULTS: From the 919 patients included, 218 (24%) improved and 95 (10%) progressed. Eleven candidate predictors for skin improvement were analysed. The final model identified high baseline mRSS and absence of tendon friction rubs as independent predictors of skin improvement. The baseline mRSS was the strongest predictor of skin improvement, independent of disease duration. An upper threshold between 18 and 25 performed best in enriching for progressors over regressors. CONCLUSIONS: Patients with advanced skin fibrosis at baseline and absence of tendon friction rubs are more likely to regress in the next year than patients with milder skin fibrosis. These evidence-based data can be implemented in clinical trial design to minimise the inclusion of patients who would regress under standard of care.

AB - OBJECTIVES: Improvement of skin fibrosis is part of the natural course of diffuse cutaneous systemic sclerosis (dcSSc). Recognising those patients most likely to improve could help tailoring clinical management and cohort enrichment for clinical trials. In this study, we aimed to identify predictors for improvement of skin fibrosis in patients with dcSSc. METHODS: We performed a longitudinal analysis of the European Scleroderma Trials And Research (EUSTAR) registry including patients with dcSSc, fulfilling American College of Rheumatology criteria, baseline modified Rodnan skin score (mRSS) ≥7 and follow-up mRSS at 12±2 months. The primary outcome was skin improvement (decrease in mRSS of >5 points and ≥25%) at 1 year follow-up. A respective increase in mRSS was considered progression. Candidate predictors for skin improvement were selected by expert opinion and logistic regression with bootstrap validation was applied. RESULTS: From the 919 patients included, 218 (24%) improved and 95 (10%) progressed. Eleven candidate predictors for skin improvement were analysed. The final model identified high baseline mRSS and absence of tendon friction rubs as independent predictors of skin improvement. The baseline mRSS was the strongest predictor of skin improvement, independent of disease duration. An upper threshold between 18 and 25 performed best in enriching for progressors over regressors. CONCLUSIONS: Patients with advanced skin fibrosis at baseline and absence of tendon friction rubs are more likely to regress in the next year than patients with milder skin fibrosis. These evidence-based data can be implemented in clinical trial design to minimise the inclusion of patients who would regress under standard of care.

U2 - 10.1136/annrheumdis-2015-208024

DO - 10.1136/annrheumdis-2015-208024

M3 - Article

VL - 75

SP - 1743

EP - 1748

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 1468-2060

IS - 10

ER -