Prevalence and clinical relevance of digital ulcers in systemic sclerosis patients from the real-life: the experience of the SPRING Registry of the Italian Society for Rheumatology.
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Orlandi Martina, De Luca Giacomo, Ferri Clodoveo, Spinella Amelia, Lumetti Federica, Costantini Riccardo Cuoghi, De Angelis Rossella, Riccieri Valeria, Bosello Silvia Laura, Cacciapaglia Fabio, Codullo Veronica, Bajocchi Gianluigi, Campochiaro Corrado, Zanframundo Giovanni, Foti Rosario, Cuomo Giovanna, Ariani Alarico, Rosato Edoardo, Girelli Francesco, Zanatta Elisabetta, Cavazzana Ilaria, Ingegnoli Francesca, De Santis Maria, Murdaca Giuseppe, Abignano Giuseppina, Giorgio Pettiti, Della Rossa Alessandra, Caminiti Maurizio, Iuliano Anna Maria, Ciano Giovanni, Beretta Lorenzo, Bagnato Gianluca, Lubrano Ennio, De Andres Ilenia, Giollo Alessandro, Saracco Marta, Agnes Cecilia, Cipolletta Edoardo, Magnani Luca, Visalli Elisa, Iandoli Carlo, Gigante Antonietta, Pellegrino Greta, Pigatto Erika, Lazzaroni Maria Grazia, Franceschini Franco, Generali Elena, Mennillo Gianna, Barsotti Simone, Mariano Giuseppa Pagano, Furini Federica, Vultaggio Licia, Parisi Simone, Peroni Clara Lisa, Bianchi Gerolamo, Fusaro Enrico, Sebastiani Gian Domenico, Govoni Marcello, D'Angelo Salvatore, Cozzi Franco, Guiducci Serena, Doria Andrea, Salvarani Carlo, Iannone Florenzo, Dagna Lorenzo, Matucci-Cerinic Marco, Bellando-Randone Silvia, Giuggioli Dilia, SPRING-SIR (Systemic Sclerosis PRogression INvestiGation group of the Italian Society of Rheumatology) coworkers
Аннотация
METHODS: SSc patients fulfilling the ACR/EULAR 2013 classification criteria without missing data on digital ulcers were enrolled in a cross-sectional study. Logistic regression models were built to test the association between the presence of DU and SSc-related features.
RESULTS: Among 1873 eligible SSc patients, the presence of DU was significantly associated with gastrointestinal involvement (OR 1.88, 2.04 and 1.74; p < 0.001) and serum ATA positivity (OR 2.15; p < 0.001), as well as with telangiectasias, sclerodactyly, digital pitting scar, and calcinosis (OR 1.40, p = 0.005; OR 3.43, p < 0.001, OR 9.12, p < 0.001 and OR 2.77, p < 0.001; respectively). In the multivariable regression models, even after adjustment for covariates, ATA positivity (OR 1.76, p = 0.039), puffy fingers (OR 2.82, p < 0.001), and a higher revEUSTAR-AI (OR 6.63, p < 0.001) emerged as risk factors for the presence of DU. Moreover, a low presence of DU was recorded in SSc patients with a history of previous immunosuppressive treatments (OR 0.53, p = 0.032).
CONCLUSION: In our Italian SSc cohort, DUs were significantly associated with the presence of puffy fingers, high revEUSTR-AI, and ATA seropositivity. Noteworthy, immunosuppressive treatments were associated with a low rate of DU, suggesting that they might contribute to the prevention of these harmful manifestations. Key Points • Digital ulcers were significantly associated with the presence of puffy fingers, high disease activity, and anti-Scl70 seropositivity. • Immunosuppressive treatments were associated with a low rate of digital ulcers, suggesting that they might contribute to the prevention of these harmful manifestations.