Evidence map›Paper›PMID 39482761›Full record

ArticleArthritis research & therapy2024

Does regression of skin thickening predict improvement of internal organ involvement and survival in patients with diffuse cutaneous systemic sclerosis? A EUSTAR analysis.

Anja Wyss, Suzana Jordan, Nicole Graf, Patricia E Carreira, Jörg Distler, Marco Matucci Cerinic, Elise Siegert, Jörg Henes, Elisabetta Zanatta, Valeria Riccieri and 11 more

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Article in Arthritis research & therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Review
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  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Anja WyssDepartment of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Suzana JordanDepartment of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Nicole GrafGraf Biostatistics, Winterthur, Switzerland.
Patricia E CarreiraServicio de Reumatología, Hospital, 12 de Octubre Avda. De Córdoba, S/N, Madrid, Spain.
Jörg DistlerDepartment of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Düsseldorf, Germany.
Marco Matucci CerinicDepartment of Medicine, Section of Rheumatology, Florence, Italy.
Elise SiegertDepartment of Rheumatology, Charité University Hospital, Berlin, Germany.
Jörg HenesCenter for Interdisciplinary Rheumatology, Immunology and Autoimmune diseases (INDIRA), University Hospital Tübingen, Tübingen, Germany.
Elisabetta ZanattaRheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
Valeria RiccieriDipartimento di Medicina Interna e Specialità Mediche, ˝Sapienza˝ Università di Roma, Rome, Italy.
Marie-Elise TruchetetRheumatology Department, Bordeaux University Hospital, Centre national de référence des maladies auto-immunes et systémiques rares Est/Sud-Ouest (RESO), Bordeaux, F-33000, France.
Fahrettin OkselFaculty of Medicine, Department of Internal Medicine, Division of Rheumatology Bornova, Ege University, Izmir, Turkey.
Mengtao LiDepartment of Rheumatology, Peking Union Medical College Hospital (West Campus), Chinese Academy of Medical Sciences, Beijing, China.
Eugene J KucharzDepartment of Internal Medicine and Rheumatology, Medical University of Silesia Katowice, Katowice, Poland.
Kilian EyerichDepartment of Dermatology, University of Freiburg, Freiburg, Germany.
Francesco Del GaldoScleroderma Programme, NIHR BRC and Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
Madelon C VonkDepartment of Rheumatic Diseases, Radboud University Medical Center, Nijmegen, Netherlands.
Anna-Maria Hoffman VoldDepartment of Rheumatology, University Hospital Oslo, Oslo, Norway.
Armando GabrielliHiller Research Unit, University Hospital Düsseldorf, Medical Faculty of Heinrich-Heine University, Düsseldorf, Germany.
Oliver DistlerDepartment of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. oliver.distler@usz.ch.
EUSTAR collaborators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePatients with diffuse cutaneous systemic sclerosis (dcSSc) frequently show spontaneous improvement of skin fibrosis. Our aim was to examine whether an improvement in skin fibrosis predicts lower likelihood of visceral organ progression and better survival.

methodsPatients from the European Scleroderma Trials and Research (EUSTAR) cohort with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, and valid mRSS at 12±3 months follow up were included. Regression/progression of skin fibrosis was defined as a decrease/increase in mRSS >5 points and ≥25% from baseline to follow up. The outcomes included progression of lung, renal, cardiac and gastrointestinal manifestations using consensus derived definitions and all-cause death. Regressive, stable and progressive patients were compared by univariate, Kaplan-Meier survival curve and Cox regression analysis.

resultsOf 1257 included patients, 883 (70.2%) were stable, 282 (22.4%) regressive, and 92 (7.3%) progressive. Regressive patients, adjusted for baseline mRSS, baseline immunosuppression, baseline FVC, and disease duration, showed a significantly lower probability of FVC decline ≥10% than progressive patients (p=0.00003), lower probability of all-cause mortality during follow up (p=0.035) compared to progressive patients. .Improvement of skin fibrosis was not associated with progression of other organ manifestations.

conclusionWe found that regression of skin fibrosis is associated with a lower probability of lung progression and better survival at follow up. The link between the disease course of skin and lung fibrosis in SSc can help to better stratify patients in clinical practice and enrich for ILD progressive patients in clinical trials.

Indexed as

Disease ProgressionScleroderma, DiffuseSkinAdultAgedCohort StudiesFemaleFibrosisHumansMaleMiddle AgedObservation studiesRare diseasesRespiratoryScleroderma and related disordersSkin

Identifiers

PMID39482761
PMCPMC11526720

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.