Joint Involvement And Aggressive Systemic Sclerosis PDF Print E-mail
Thursday, 16 September 2010 09:16
Clinical joint involvement is strikingly common in patients with systemic sclerosis (scleroderma) and is associated with a more active and severe disease phenotype, according to an analysis of the world’s largest systemic sclerosis (SSc) registry.

Synovitis proved to have a particularly strong association with systemic inflammation in this study. However, Synovitis often occurred in concert with joint contractures and/or tendon friction rubs, raising the possibility of a shared underlying mechanism in their development , Dr. Jérôme Avouac said at the annual European Congress of Rheumatology.

He presented an analysis of joint symptoms and their clinical implications in 7,286 patients with systemic sclerosis (SSc) enrolled in the EULAR Scleroderma Trials and Research (EUSTAR) registry, the world’s largest SSc database. Of registrants, 58% had the limited cutaneous subtype of SSc, 33% had the diffuse cutaneous subtype, and 9% were not classified.

Synovitis, joint contractures, and tendon friction rubs more prevalent in patients with the diffuse cutaneous subtype noted Dr. Avouac of Cochin Hospital, Paris.

Active disease, as defined by the 17-point dermal ultrasound, modified Rodnan skin scoring system, was present in 29% of the overall study population. Synovitis was associated with a highly significant 70% increased likelihood of having active disease, while tendon friction rubs were associated with a 51% increased rate. In contrast, joint contractures had no impact upon the risk of having active disease.

Synovitis was also associated with a 47% increased likelihood of having muscle weakness, a 49% increase in the risk of having elevated systolic pulmonary artery pressure, a 49% increase in the odds of having elevation of acute phase reactants, and a 29% increase in anti-topoisomerase-1 antibody positivity.

Patients with joint contractures were significantly more likely to have digital ulcerations (93% increased risk), elevated systolic pulmonary artery pressure (38% increased risk), muscle weakness (41% increase), and pulmonary fibrosis (23% increased risk), the rheumatologist continued.

Tendon friction rubs were associated with a 21% increased likelihood of experiencing digital ulceration, a 22% increase in pulmonary fibrosis, and a 38% greater likelihood of proteinuria.

These study findings provide support for making early detection of articular involvement in SSc a disease-management priority, according to Dr. Avouac.

He noted, however, that this was a cross-sectional analysis. Ongoing prospective follow-up of the EUSTAR registry participants will enable investigators to make a definitive determination of the merits of articular involvement as a predictor of disease severity

Source: Jancin, B (2010), "Joint Involvement Predicts Aggressive Systemic Sclerosis", Skin and Allergy News, viewed online at http://bit.ly/dxrK4J
 
More articles :

» Genetic Accelerator Linked To Most Severe Cases of Lupus

A "genetic accelerator" is responsible for the most severe cases of Lupus (), an autoimmune disease: the accelerator, called enhancer HS1.2, speeds up the activity of some critical genes of the immune system involved in the disease.A team of Italian...

» arGentis Issued Key Patent Related to Treating Fibrosing Diseases by Induction of Immune Tolerance

arGentis Pharmaceuticals, LLC today announced the issuance of United States patent 7,718,765, entitled “Methods for Treating Fibrosing Diseases by Induction of Immune Tolerance." The issued patent, based on the seminal research of Arnold E....

» Central Nervous System Manifestations In Scleroderma

We at the believe that knowledge is indeed, power. It was this belief that became the primary motivation for the creation of our website. It was meant to empower all patients to take control of the disease through news and informative articles, and...

» Promedior Announces Publication of New Research Demonstrating Pentraxin-2/SAP is a Potent Inhibitor of Pulmonary Fibrosis

Promedior, Inc., a clinical stage biotechnology company developing novel therapies to treat fibrotic and inflammatory diseases, announced today the publication of collaborative research in the International Journal of Biochemistry and Cell Biology...

» Getting to the Root of Raynaud’s

Dr. Fredrick Wigley is a professor of medicine at Johns Hopkins School of Medicine and director of the Johns Hopkins Scleroderma  Center. A rheumatologist, he has been studying Raynaud’s since 1978. The New York Times recently interviewed Dr....

» Stanford Medical Researchers Discover Master Regulator of Skin Development

The surface of your skin, called the , is a complex mixture of many different cell types — each with a very specific job. The production, or differentiation, of such a sophisticated tissue requires an immense amount of coordination at the cellular...