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Classification, categorization and essential items for digital ulcer evaluation in systemic sclerosis: a DeSScipher/European Scleroderma Trials and Research group (EUSTAR) survey.
- Source :
-
Arthritis research & therapy [Arthritis Res Ther] 2019 Jan 24; Vol. 21 (1), pp. 35. Date of Electronic Publication: 2019 Jan 24. - Publication Year :
- 2019
-
Abstract
- Background: A consensus on digital ulcer (DU) definition in systemic sclerosis (SSc) has been recently reached (Suliman et al., J Scleroderma Relat Disord 2:115-20, 2017), while for their evaluation, classification and categorisation, it is still missing. The aims of this study were to identify a set of essential items for digital ulcer (DU) evaluation, to assess if the existing DU classification was useful and feasible in clinical practice and to investigate if the new categorisation was preferred to the simple distinction of DU in recurrent and not recurrent, in patients with systemic sclerosis (SSc).<br />Methods: DeSScipher is the largest European multicentre study on SSc. It consists of five observational trials (OTs), and one of them, OT1, is focused on DU management. The DeSScipher OT1 items on DU that reached ≥ 60% of completion rate were administered to EUSTAR (European Scleroderma Trials and Research group) centres via online survey. Questions about feasibility and usefulness of the existing DU classification (DU due to digital pitting scars, to loss of tissue, derived from calcinosis and gangrene) and newly proposed categorisation (episodic, recurrent and chronic) were also asked.<br />Results: A total of 84/148 (56.8%) EUSTAR centres completed the questionnaire. DeSScipher items scored by ≥ 70% of the participants as essential and feasible for DU evaluation were the number of DU defined as a loss of tissue (level of agreement 92%), recurrent DU (84%) and number of new DU (74%). For 65% of the centres, the proposed classification of DU was considered useful and feasible in clinical practice. Moreover, 80% of the centres preferred the categorisation of DU in episodic, recurrent and chronic to simple distinction in recurrent/not recurrent DU.<br />Conclusions: For clinical practice, EUSTAR centres identified only three essential items for DU evaluation and considered the proposed classification and categorisation as useful and feasible. The set of items needs to be validated while further implementation of DU classification and categorisation is warranted.<br />Trial Registration: Observational trial on DU (OT1) is one of the five trials of the DeSScipher project (ClinicalTrials.gov; OT1 Identifier: NCT01836263 , posted on April 19, 2013).
- Subjects :
- Adult
Bosentan therapeutic use
Calcium Channel Blockers therapeutic use
Drug Therapy, Combination
European Union
Female
Humans
Iloprost therapeutic use
Male
Middle Aged
Prospective Studies
Scleroderma, Systemic classification
Scleroderma, Systemic diagnosis
Sildenafil Citrate therapeutic use
Skin Ulcer classification
Skin Ulcer diagnosis
Surveys and Questionnaires
Fingers
Scleroderma, Systemic drug therapy
Skin Ulcer drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1478-6362
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Arthritis research & therapy
- Publication Type :
- Academic Journal
- Accession number :
- 30678703
- Full Text :
- https://doi.org/10.1186/s13075-019-1822-1