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Gordon JK, Girish G, Berrocal VJ, Zhang M, Hatzis C, Assassi S, Bernstein EJ, Domsic RT, Hant FN, Hinchcliff M, Schiopu E, Steen VD, Frech TM, Khanna D. Reliability and Validity of the Tender and Swollen Joint Counts and the Modified Rodnan Skin Score in Early Diffuse Cutaneous Systemic Sclerosis: Analysis from the Prospective Registry of Early Systemic Sclerosis Cohort. J Rheumatol 2017; 44:791-794. [PMID: 28298560 DOI: 10.3899/jrheum.160654] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine the inter/intraobserver reliability of the tender and swollen joint counts (TJC, SJC) and the modified Rodnan Skin Score (mRSS) in diffuse cutaneous systemic sclerosis (dcSSc) and to assess content validity of the TJC/SJC. METHODS Ten rheumatologists completed the SJC, TJC, and mRSS on 7 patients. Musculoskeletal ultrasound (MSUS) was performed. RESULTS Interobserver and intraobserver reliability for the TJC was 0.97 and 0.99, for the SJC was 0.24 and 0.71, and for the mRSS was 0.81 and 0.94, respectively. MSUS abnormalities did not correspond with SJC/TJC. CONCLUSION We demonstrate excellent inter- and intraobserver reliability for the mRSS and TJC in dcSSc. However, the SJC and TJC did not correspond to MSUS.
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Affiliation(s)
- Jessica K Gordon
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA. .,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program.
| | - Gandikota Girish
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Veronica J Berrocal
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Meng Zhang
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Christopher Hatzis
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Shervin Assassi
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Elana J Bernstein
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Robyn T Domsic
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Faye N Hant
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Monique Hinchcliff
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Elena Schiopu
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Virginia D Steen
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Tracy M Frech
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
| | - Dinesh Khanna
- From the Department of Rheumatology, and Department of Epidemiology and Biostatistics, Hospital for Special Surgery; Department of Rheumatology, Columbia University, New York, New York; Department of Radiology, and Department of Biostatistics, University of Michigan; University of Michigan Scleroderma Program, Ann Arbor, Michigan; Department of Rheumatology, University of Texas, Houston, Texas; Department of Rheumatology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Rheumatology, Medical University of South Carolina, Charleston, South Carolina; Department of Rheumatology, Northwestern University, Chicago, Illinois; Department of Rheumatology, Georgetown University, Washington, DC; Department of Rheumatology, University of Utah, Salt Lake City, Utah, USA.,J.K. Gordon, MD, MSc, Department of Rheumatology, Hospital for Special Surgery; G. Girish, MBBS, Department of Radiology, University of Michigan; V.J. Berrocal, MSc, PhD, Department of Biostatistics, University of Michigan; M. Zhang, PhD, Department of Epidemiology and Biostatistics, Hospital for Special Surgery; C. Hatzis, BA, Department of Rheumatology, Hospital for Special Surgery; S. Assassi, MD, MS, Department of Rheumatology, University of Texas; E.J. Bernstein, MD, MSc, Department of Rheumatology, Columbia University; R.T. Domsic, MD, MPH, Department of Rheumatology, University of Pittsburgh; F.N. Hant, DO, Department of Rheumatology, Medical University of South Carolina; M. Hinchcliff, MD, MS, Department of Rheumatology, Northwestern University; E. Schiopu, MD, University of Michigan Scleroderma Program; V.D. Steen, MD, Department of Rheumatology, Georgetown University; T.M. Frech, MD, MS, Department of Rheumatology, University of Utah; D. Khanna, MD, MS, University of Michigan Scleroderma Program
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Avouac J, Riemekasten G, Meune C, Ruiz B, Kahan A, Allanore Y. Autoantibodies against Endothelin 1 Type A Receptor Are Strong Predictors of Digital Ulcers in Systemic Sclerosis. J Rheumatol 2015; 42:1801-7. [PMID: 26233500 DOI: 10.3899/jrheum.150061] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To determine the predictive value of functional autoantibodies against vascular receptors for the development of ischemic digital ulcers (DU) in patients with systemic sclerosis (SSc). METHODS Angiotensin II Type 1 receptor (AT1R) and endothelin 1 Type A receptor (ETAR) autoantibodies were measured at baseline in a prospective cohort of 90 patients with SSc together with 5 validated angiogenic markers. The primary outcome was the occurrence of at least 1 new ischemic DU during the 5-year followup. RESULTS Twenty-four patients developed at least 1 new DU during the followup period. Univariate Cox analysis revealed that concentrations above the median value of anti-AT1R and anti-ETAR antibodies were predictive of the occurrence of ischemic DU (HR 2.85, 95% CI 1.19-6.84 and HR 3.39, 95% CI 1.35-8.50, respectively). A first multivariate Cox analysis including functional autoantibodies and clinical predictors of new DU confirmed anti-ETAR autoantibodies as independent predictors of the occurrence of new ischemic DU (HR 3.15, 95% CI 1.22-8.13) together with a history of DU at baseline. In a second model implemented with angiogenic markers, anti-ETAR autoantibodies remained an independent predictor of the occurrence of new ischemic DU (HR 9.59, 95% CI 1.75-52.64) together with the presence at baseline of active DU or history of DU. CONCLUSION Anti-ETAR autoantibodies can be used together with the presence of current or past DU to identify patients with SSc who are at risk for the development of subsequent DU. These autoantibodies may allow for earlier management and therapeutic intervention.
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Affiliation(s)
- Jérôme Avouac
- From the Paris Descartes University, Sorbonne Paris Cité, Rheumatology A Department, Cochin Hospital; Paris Descartes University, Institut National de la Santé Et de la Recherche Médicale, Unité 1016 (INSERM U1016), and Centre National de la Recherche Scientifique, Unité Mixte de Recherche 8104 (CNRS UMR8104), Cochin Institute; Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, Bobigny, France and Unité Mixte de Recherche 942 (UMR 942), Paris, France; Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine, Berlin, Germany.J. Avouac, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; G. Riemekasten, MD, PhD, Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine; C. Meune, MD, PhD, Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, and UMR 942; B. Ruiz, Assistant Ingenior, Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; A. Kahan, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital; Y. Allanore, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute.
| | - Gabriela Riemekasten
- From the Paris Descartes University, Sorbonne Paris Cité, Rheumatology A Department, Cochin Hospital; Paris Descartes University, Institut National de la Santé Et de la Recherche Médicale, Unité 1016 (INSERM U1016), and Centre National de la Recherche Scientifique, Unité Mixte de Recherche 8104 (CNRS UMR8104), Cochin Institute; Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, Bobigny, France and Unité Mixte de Recherche 942 (UMR 942), Paris, France; Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine, Berlin, Germany.J. Avouac, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; G. Riemekasten, MD, PhD, Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine; C. Meune, MD, PhD, Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, and UMR 942; B. Ruiz, Assistant Ingenior, Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; A. Kahan, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital; Y. Allanore, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute
| | - Christophe Meune
- From the Paris Descartes University, Sorbonne Paris Cité, Rheumatology A Department, Cochin Hospital; Paris Descartes University, Institut National de la Santé Et de la Recherche Médicale, Unité 1016 (INSERM U1016), and Centre National de la Recherche Scientifique, Unité Mixte de Recherche 8104 (CNRS UMR8104), Cochin Institute; Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, Bobigny, France and Unité Mixte de Recherche 942 (UMR 942), Paris, France; Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine, Berlin, Germany.J. Avouac, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; G. Riemekasten, MD, PhD, Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine; C. Meune, MD, PhD, Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, and UMR 942; B. Ruiz, Assistant Ingenior, Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; A. Kahan, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital; Y. Allanore, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute
| | - Barbara Ruiz
- From the Paris Descartes University, Sorbonne Paris Cité, Rheumatology A Department, Cochin Hospital; Paris Descartes University, Institut National de la Santé Et de la Recherche Médicale, Unité 1016 (INSERM U1016), and Centre National de la Recherche Scientifique, Unité Mixte de Recherche 8104 (CNRS UMR8104), Cochin Institute; Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, Bobigny, France and Unité Mixte de Recherche 942 (UMR 942), Paris, France; Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine, Berlin, Germany.J. Avouac, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; G. Riemekasten, MD, PhD, Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine; C. Meune, MD, PhD, Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, and UMR 942; B. Ruiz, Assistant Ingenior, Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; A. Kahan, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital; Y. Allanore, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute
| | - André Kahan
- From the Paris Descartes University, Sorbonne Paris Cité, Rheumatology A Department, Cochin Hospital; Paris Descartes University, Institut National de la Santé Et de la Recherche Médicale, Unité 1016 (INSERM U1016), and Centre National de la Recherche Scientifique, Unité Mixte de Recherche 8104 (CNRS UMR8104), Cochin Institute; Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, Bobigny, France and Unité Mixte de Recherche 942 (UMR 942), Paris, France; Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine, Berlin, Germany.J. Avouac, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; G. Riemekasten, MD, PhD, Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine; C. Meune, MD, PhD, Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, and UMR 942; B. Ruiz, Assistant Ingenior, Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; A. Kahan, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital; Y. Allanore, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute
| | - Yannick Allanore
- From the Paris Descartes University, Sorbonne Paris Cité, Rheumatology A Department, Cochin Hospital; Paris Descartes University, Institut National de la Santé Et de la Recherche Médicale, Unité 1016 (INSERM U1016), and Centre National de la Recherche Scientifique, Unité Mixte de Recherche 8104 (CNRS UMR8104), Cochin Institute; Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, Bobigny, France and Unité Mixte de Recherche 942 (UMR 942), Paris, France; Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine, Berlin, Germany.J. Avouac, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; G. Riemekasten, MD, PhD, Department of Rheumatology, Clinical Immunology, and German Rheumatism Research Centre, a Leibniz institute, Charité-University Medicine; C. Meune, MD, PhD, Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, and UMR 942; B. Ruiz, Assistant Ingenior, Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute; A. Kahan, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital; Y. Allanore, MD, PhD, Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital, and Paris Descartes University, INSERM U1016, and CNRS UMR8104, Cochin Institute
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