Evidence map›Paper›PMID 40795829›Full record

ArticleRheumatology (Oxford, England)2025

Oesophageal dysmotility patterns are associated with distinct clinical phenotypes and prognosis in patients with systemic sclerosis.

Luis G Alcala-Gonzalez, Alfredo Guillen-Del-Castillo, Ariadna Aguilar, Claudia Barber, Carolina Malagelada, Laura Polo Figueras, Laura Triginer, Claudia Codina-Clavaguera, Michael Hughes, Jordi Serra and 2 more

Abstract read
In one paragraph

Article in Rheumatology (Oxford, England), 2025. 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.

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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

12 authors.

Luis G Alcala-GonzalezDigestive System Research Unit, Department of Digestive Diseases, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0003-3247-1539
Alfredo Guillen-Del-CastilloSystemic Autoimmune Diseases Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0003-0626-507X
Ariadna AguilarDigestive System Research Unit, Department of Digestive Diseases, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0002-2040-311X
Claudia BarberDigestive System Research Unit, Department of Digestive Diseases, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0003-4711-2731
Carolina MalageladaDigestive System Research Unit, Department of Digestive Diseases, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0001-7097-1492
Laura Polo FiguerasDigestive System Research Unit, Department of Digestive Diseases, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0009-0007-1439-2171
Laura TriginerSystemic Autoimmune Diseases Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0009-0009-2224-2987
Claudia Codina-ClavagueraSystemic Autoimmune Diseases Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0002-8083-5897
Michael HughesDivision of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.ORCID 0000-0003-3361-4909
Jordi SerraDigestive System Research Unit, Department of Digestive Diseases, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0003-2120-6270
Carmen P Simeón-AznarSystemic Autoimmune Diseases Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0003-3390-9029
Zsuzsanna H McMahanDivision of Rheumatology, Department of Medicine, UTHealth Houston, Houston, TX, USA.ORCID 0000-0001-6461-8940

Funding

European Union PI22/01804Instituto de Salud Carlos IIINeurogastroenterology and MotilityNIH HHS 1 R01 AR081382-01A1Spanish Association of Gastroenterology
6 · The paper itself

Abstract

objectivesOesophageal dysmotility is a common manifestation of SSc, contributing to substantial morbidity. We sought to determine whether oesophageal dysmotility patterns by high-resolution oesophageal manometry were associated with distinct SSc clinical phenotypes and different outcomes.

methodsWe analysed a cohort of SSc patients with detailed clinical and immunological data. Oesophageal motility was classified using Chicago 4.0 criteria, and baseline characteristics were compared across motility patterns [absent contractility (AC), ineffective oesophageal motility (IEM) and normal motility]. Associations with adverse outcomes (death or lung transplantation) were evaluated using Kaplan-Meier and Cox regression analyses.

resultsOur cohort included 201 patients with SSc (84% female, mean age 45 ± 17 years, follow-up 442 person-years). Oesophageal dysmotility patterns were classified as AC in 86 (43%), IEM in 57 (28%) and normal motility in 58 (29%). AC was associated with dcSSc, more severe digital ulcers, gastric vascular ectasia, anti-Ro60 antibodies and a late pattern on nailfold capillaroscopy (P < 0.05), while IEM was linked to limited SSc, anti-centromere antibodies and an early/active nailfold pattern. Multivariate time-to-event analysis identified AC as an independent risk factor for lung transplantation (HR = 7.004, 95%CI: 1.481-33.135, P = 0.014) after adjusting for both interstitial lung disease and male sex, and for SSc-related death (HR = 3.472, 95%CI: 1.071-10.969, P = 0.038) after adjusting for DcSSc and interstitial lung disease.

conclusionsWe found that patients with AC and IEM have distinct clinical phenotypes, suggesting they are distinct entities. In patients with SSc, AC is independently associated with worse outcomes. These data suggest that HREM may be useful in risk stratification and outcome predictions in patients with SSc.

Indexed as

Esophageal Motility DisordersScleroderma, SystemicAdultFemaleHumansLung TransplantationMaleManometryMiddle AgedPhenotypePrognosisgastrointestinal involvementhigh-resolution manometryoesophageal dysmotilitysystemic sclerosis

Identifiers

PMID40795829
PMCPMC12671867

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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.