ArticleArthritis research & therapy2020
ACE inhibitors in SSc patients display a risk factor for scleroderma renal crisis-a EUSTAR analysis.
Article in Arthritis research & therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 64 citations in OpenAlex.
- Older Age, Steroid Exposure, and Digital Pitting Scars Predict Poor Outcomes in Scleroderma Renal Crisis: A 30-Year Retrospective Cohort Study.Mediterranean journal of rheumatology · 2026Article
- Emergency in pediatric rheumatology: a narrative review.Frontiers in medicine · 2026Review
- Novel Compounds in Targeting the α1-adrenoceptor for Antihypertensive Therapy.Cardiovascular & hematological agents in medicinal chemistry · 2026Review
- Authors' Reply: Chronic Lesions in Scleroderma Renal Crisis: A Protective Clue?Journal of the American Society of Nephrology : JASN · 2026Article
- Chronic Lesions in Scleroderma Renal Crisis: A Protective Clue?Journal of the American Society of Nephrology : JASN · 2026Article
- [S2k guidelines on diagnostics and treatment of systemic sclerosis : Full version].Zeitschrift fur Rheumatologie · 2025Review
- Absence of Functional Autoantibodies Targeting Angiotensin II Receptor Type 1 and Endothelin-1 Type A Receptor in Circulation and Purified IgG From Patients With Systemic Sclerosis.Arthritis & rheumatology (Hoboken, N.J.) · 2025Article
- Wound, pressure ulcer, and burn guidelines (2023)-4: Guidelines for the management of connective tissue disease/vasculitis-associated skin ulcers, third edition.The Journal of dermatology · 2025Article
- Autoantibodies in systemic sclerosis overlap syndrome and their correlation with organ damage and survival.Annals of medicine · 2024Article
- Biomarkers reflecting the pathogenesis, clinical manifestations, and guide therapeutic approach in systemic sclerosis: a narrative review.Clinical rheumatology · 2024Review
- Heart involvement in patients with systemic sclerosis-what have we learned about it in the last 5 years.Rheumatology international · 2024Review
- Emergencies in inflammatory rheumatic diseases.Rheumatology international · 2024Review
- Therapeutic strategies for primary heart involvement in systemic sclerosis.Rheumatology and immunology research · 2024Article
- Systemic Sclerosis-Associated Pulmonary Arterial Hypertension: From Bedside to Bench and Back Again.International journal of molecular sciences · 2024Review
- Scleroderma renal crisis, an increasingly rare but persistently challenging condition: a retrospective cohort study.Rheumatology advances in practice · 2024Article
- Renal Disease and Systemic Sclerosis: an Update on Scleroderma Renal Crisis.Clinical reviews in allergy & immunology · 2023Review
- Systemic sclerosis.Lancet (London, England) · 2023Review
- Cannabinoid Compounds as a Pharmacotherapeutic Option for the Treatment of Non-Cancer Skin Diseases.Cells · 2022Review
- Diagnosis and treatment of thrombotic microangiopathy.International journal of laboratory hematology · 2022Review
- Kidney Involvement in Systemic Sclerosis.Journal of personalized medicine · 2022Review
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 4 countries.
Funding
Abstract
objectivesTo investigate the effect of ACE inhibitors (ACEi) on the incidence of scleroderma renal crisis (SRC) when given prior to SRC in the prospectively collected cohort from the European Scleroderma Trial and Research Group (EUSTAR).
methodsSSc patients without prior SRC and at least one follow-up visit were included and analyzed regarding SRC, arterial hypertension, and medication focusing on antihypertensive medication and glucocorticoids (GC).
resultsOut of 14,524 patients in the database, we identified 7648 patients with at least one follow-up. In 27,450 person-years (py), 102 patients developed SRC representing an incidence of 3.72 (3.06-4.51) per 1000 py. In a multivariable time-to-event analysis adjusted for age, sex, disease severity, and onset, 88 of 6521 patients developed SRC. The use of ACEi displayed an increased risk for the development of SRC with a hazard ratio (HR) of 2.55 (95% confidence interval (CI) 1.65-3.95). Adjusting for arterial hypertension resulted in a HR of 2.04 (95%CI 1.29-3.24). There was no evidence for an interaction of ACEi and arterial hypertension (HR 0.83, 95%CI 0.32-2.13, p = 0.69). Calcium channel blockers (CCB), angiotensin receptor blockers (ARB), endothelin receptor antagonists, and GC-mostly in daily dosages below 15 mg of prednisolone-did not influence the hazard for SRC.
conclusionsACEi in SSc patients with concomitant arterial hypertension display an independent risk factor for the development of SRC but are still first choice in SRC treatment. ARBs might be a safe alternative, yet the overall safety of alternative antihypertensive drugs in SSc patients needs to be further studied.
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