نبذة مختصرة : OBJECTIVES: Nailfold videocapillaroscopy (NVC) plays a well-established role in differentiating primary from secondary Raynaud's phenomenon due to systemic sclerosis (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 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 12- or 24-month follow-up. NVC images at enrolment were quantitatively and qualitatively evaluated according to the standardised definitions of the EULAR Study Group on Microcirculation in Rheumatic Diseases. Uni- and multivariable logistic regression modelling (ULR, MLR) was performed. RESULTS: 257/334 (76.9%) patients developed novel overall severe organ involvement/progression. Following MLR, normal capillary density was associated with less frequent novel overall severe organ involvement/progression (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 standardised way, we were underpowered to detect associations with infrequent severe organ involvement/progression.
Processing Request
No Comments.