1. Nailfold capillaroscopy in SSc: innocent bystander or promising biomarker for novel severe organ involvement/progression?
- Author
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Vanhaecke, Amber, Cutolo, Maurizio, Distler, Oliver, Riccieri, Valeria, Allanore, Yannick, Denton, Christopher P, Hachulla, Eric, Ingegnoli, Francesca, Deschepper, Ellen, Avouac, Jérôme, Jordan, Suzana, Launay, David, Melsens, Karin, Pizzorni, Carmen, Sulli, Alberto, Vasile, Massimiliano, Herrick, Ariane L, and Smith, Vanessa
- Subjects
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DISEASE progression , *BIOMARKERS , *RESEARCH , *SKIN diseases , *NAILS (Anatomy) , *CAPILLARIES , *PULMONARY hypertension , *PERIPHERAL vascular diseases , *SYSTEMIC scleroderma , *MICROCIRCULATION , *MULTIPLE organ failure , *SEVERITY of illness index , *RISK assessment , *DESCRIPTIVE statistics , *ANGIOGRAPHY , *LOGISTIC regression analysis , *ODDS ratio , *HEMORRHAGE , *DISEASE risk factors , *EVALUATION - Abstract
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. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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