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Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study
OBJECTIVE: To identify nailfold videocapillaroscopic features and other clinical risk factors for new digital ulcers (DUs) during a 6‐month period in patients with systemic sclerosis (SSc). METHODS: In this multicenter, prospective, observational cohort study, the videoCAPillaroscopy (CAP) study, we...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129545/ https://www.ncbi.nlm.nih.gov/pubmed/27111549 http://dx.doi.org/10.1002/art.39718 |
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author | Cutolo, Maurizio Herrick, Ariane L. Distler, Oliver Becker, Mike O. Beltran, Emma Carpentier, Patrick Ferri, Clodoveo Inanç, Murat Vlachoyiannopoulos, Panayiotis Chadha‐Boreham, Harbajan Cottreel, Emmanuelle Pfister, Thomas Rosenberg, Daniel Torres, Juan V. Smith, Vanessa Cutolo, Maurizio Herrick, Ariane L. Distler, Oliver Becker, Mike Beltran, Emma Carpentier, Patrick Ferri, Clodoveo Inanç, Murat Vlachoyiannopoulos, Panayiotis Smith, Vanessa Erlacher, L Hirschl, M Kiener, HP Pilger, E Smith, V Blockmans, D Wautrecht, J‐C Becvár, R Carpentier, P Frances, C Lok, C Sparsa, A Hachulla, E Quere, I Allanore, Y Agard, C Riemekasten, G Hunzelmann, N Stücker, M Ahmadi‐Simab, K Sunderkötter, C Wohlrab, J Müller‐Ladner, U Schneider, M Vlachoyianopoulos, P Vassilopoulos, D Drosos, A Antonopoulos, A Balbir‐Gurman, A Langevitz, P Rosner, I Levy, Y Cutolo, M Bombardieri, S Ferraccioli, G Mazzuca, S Grassi, W Lunardi, C Airó, P Riccieri, V Voskuyl, AE Schuerwegh, A Santos, L Rodrigues, AC Grilo, A Amaral, MC Román Ivorra, JA Castellvi, I Distler, O Spertini, F Müller, R Inanç, M Oksel, F Turkcapar, N Herrick, A Denton, C McHugh, N Chattopadhyay, C Hall, F Buch, M |
author_facet | Cutolo, Maurizio Herrick, Ariane L. Distler, Oliver Becker, Mike O. Beltran, Emma Carpentier, Patrick Ferri, Clodoveo Inanç, Murat Vlachoyiannopoulos, Panayiotis Chadha‐Boreham, Harbajan Cottreel, Emmanuelle Pfister, Thomas Rosenberg, Daniel Torres, Juan V. Smith, Vanessa Cutolo, Maurizio Herrick, Ariane L. Distler, Oliver Becker, Mike Beltran, Emma Carpentier, Patrick Ferri, Clodoveo Inanç, Murat Vlachoyiannopoulos, Panayiotis Smith, Vanessa Erlacher, L Hirschl, M Kiener, HP Pilger, E Smith, V Blockmans, D Wautrecht, J‐C Becvár, R Carpentier, P Frances, C Lok, C Sparsa, A Hachulla, E Quere, I Allanore, Y Agard, C Riemekasten, G Hunzelmann, N Stücker, M Ahmadi‐Simab, K Sunderkötter, C Wohlrab, J Müller‐Ladner, U Schneider, M Vlachoyianopoulos, P Vassilopoulos, D Drosos, A Antonopoulos, A Balbir‐Gurman, A Langevitz, P Rosner, I Levy, Y Cutolo, M Bombardieri, S Ferraccioli, G Mazzuca, S Grassi, W Lunardi, C Airó, P Riccieri, V Voskuyl, AE Schuerwegh, A Santos, L Rodrigues, AC Grilo, A Amaral, MC Román Ivorra, JA Castellvi, I Distler, O Spertini, F Müller, R Inanç, M Oksel, F Turkcapar, N Herrick, A Denton, C McHugh, N Chattopadhyay, C Hall, F Buch, M |
author_sort | Cutolo, Maurizio |
collection | PubMed |
description | OBJECTIVE: To identify nailfold videocapillaroscopic features and other clinical risk factors for new digital ulcers (DUs) during a 6‐month period in patients with systemic sclerosis (SSc). METHODS: In this multicenter, prospective, observational cohort study, the videoCAPillaroscopy (CAP) study, we evaluated 623 patients with SSc from 59 centers (14 countries). Patients were stratified into 2 groups: a DU history group and a no DU history group. At enrollment, patients underwent detailed nailfold videocapillaroscopic evaluation and assessment of demographic characteristics, DU status, and clinical and SSc characteristics. Risk factors for developing new DUs were assessed using univariable and multivariable logistic regression (MLR) analyses. RESULTS: Of the 468 patients in the DU history group (mean ± SD age 54.0 ± 13.7 years), 79.5% were female, 59.8% had limited cutaneous SSc, and 22% developed a new DU during follow‐up. The strongest risk factors for new DUs identified by MLR in the DU history group included the mean number of capillaries per millimeter in the middle finger of the dominant hand, the number of DUs (categorized as 0, 1, 2, or ≥3), and the presence of critical digital ischemia. The receiver operating characteristic (ROC) of the area under the curve (AUC) of the final MLR model was 0.738 (95% confidence interval [95% CI] 0.681–0.795). Internal validation through bootstrap generated a ROC AUC of 0.633 (95% CI 0.510–0.756). CONCLUSION: This international prospective study, which included detailed nailfold videocapillaroscopic evaluation and extensive clinical characterization of patients with SSc, identified the mean number of capillaries per millimeter in the middle finger of the dominant hand, the number of DUs at enrollment, and the presence of critical digital ischemia at enrollment as risk factors for the development of new DUs. |
format | Online Article Text |
id | pubmed-5129545 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-51295452016-11-30 Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study Cutolo, Maurizio Herrick, Ariane L. Distler, Oliver Becker, Mike O. Beltran, Emma Carpentier, Patrick Ferri, Clodoveo Inanç, Murat Vlachoyiannopoulos, Panayiotis Chadha‐Boreham, Harbajan Cottreel, Emmanuelle Pfister, Thomas Rosenberg, Daniel Torres, Juan V. Smith, Vanessa Cutolo, Maurizio Herrick, Ariane L. Distler, Oliver Becker, Mike Beltran, Emma Carpentier, Patrick Ferri, Clodoveo Inanç, Murat Vlachoyiannopoulos, Panayiotis Smith, Vanessa Erlacher, L Hirschl, M Kiener, HP Pilger, E Smith, V Blockmans, D Wautrecht, J‐C Becvár, R Carpentier, P Frances, C Lok, C Sparsa, A Hachulla, E Quere, I Allanore, Y Agard, C Riemekasten, G Hunzelmann, N Stücker, M Ahmadi‐Simab, K Sunderkötter, C Wohlrab, J Müller‐Ladner, U Schneider, M Vlachoyianopoulos, P Vassilopoulos, D Drosos, A Antonopoulos, A Balbir‐Gurman, A Langevitz, P Rosner, I Levy, Y Cutolo, M Bombardieri, S Ferraccioli, G Mazzuca, S Grassi, W Lunardi, C Airó, P Riccieri, V Voskuyl, AE Schuerwegh, A Santos, L Rodrigues, AC Grilo, A Amaral, MC Román Ivorra, JA Castellvi, I Distler, O Spertini, F Müller, R Inanç, M Oksel, F Turkcapar, N Herrick, A Denton, C McHugh, N Chattopadhyay, C Hall, F Buch, M Arthritis Rheumatol Systemic Sclerosis OBJECTIVE: To identify nailfold videocapillaroscopic features and other clinical risk factors for new digital ulcers (DUs) during a 6‐month period in patients with systemic sclerosis (SSc). METHODS: In this multicenter, prospective, observational cohort study, the videoCAPillaroscopy (CAP) study, we evaluated 623 patients with SSc from 59 centers (14 countries). Patients were stratified into 2 groups: a DU history group and a no DU history group. At enrollment, patients underwent detailed nailfold videocapillaroscopic evaluation and assessment of demographic characteristics, DU status, and clinical and SSc characteristics. Risk factors for developing new DUs were assessed using univariable and multivariable logistic regression (MLR) analyses. RESULTS: Of the 468 patients in the DU history group (mean ± SD age 54.0 ± 13.7 years), 79.5% were female, 59.8% had limited cutaneous SSc, and 22% developed a new DU during follow‐up. The strongest risk factors for new DUs identified by MLR in the DU history group included the mean number of capillaries per millimeter in the middle finger of the dominant hand, the number of DUs (categorized as 0, 1, 2, or ≥3), and the presence of critical digital ischemia. The receiver operating characteristic (ROC) of the area under the curve (AUC) of the final MLR model was 0.738 (95% confidence interval [95% CI] 0.681–0.795). Internal validation through bootstrap generated a ROC AUC of 0.633 (95% CI 0.510–0.756). CONCLUSION: This international prospective study, which included detailed nailfold videocapillaroscopic evaluation and extensive clinical characterization of patients with SSc, identified the mean number of capillaries per millimeter in the middle finger of the dominant hand, the number of DUs at enrollment, and the presence of critical digital ischemia at enrollment as risk factors for the development of new DUs. John Wiley and Sons Inc. 2016-09-28 2016-10 /pmc/articles/PMC5129545/ /pubmed/27111549 http://dx.doi.org/10.1002/art.39718 Text en © 2016 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Systemic Sclerosis Cutolo, Maurizio Herrick, Ariane L. Distler, Oliver Becker, Mike O. Beltran, Emma Carpentier, Patrick Ferri, Clodoveo Inanç, Murat Vlachoyiannopoulos, Panayiotis Chadha‐Boreham, Harbajan Cottreel, Emmanuelle Pfister, Thomas Rosenberg, Daniel Torres, Juan V. Smith, Vanessa Cutolo, Maurizio Herrick, Ariane L. Distler, Oliver Becker, Mike Beltran, Emma Carpentier, Patrick Ferri, Clodoveo Inanç, Murat Vlachoyiannopoulos, Panayiotis Smith, Vanessa Erlacher, L Hirschl, M Kiener, HP Pilger, E Smith, V Blockmans, D Wautrecht, J‐C Becvár, R Carpentier, P Frances, C Lok, C Sparsa, A Hachulla, E Quere, I Allanore, Y Agard, C Riemekasten, G Hunzelmann, N Stücker, M Ahmadi‐Simab, K Sunderkötter, C Wohlrab, J Müller‐Ladner, U Schneider, M Vlachoyianopoulos, P Vassilopoulos, D Drosos, A Antonopoulos, A Balbir‐Gurman, A Langevitz, P Rosner, I Levy, Y Cutolo, M Bombardieri, S Ferraccioli, G Mazzuca, S Grassi, W Lunardi, C Airó, P Riccieri, V Voskuyl, AE Schuerwegh, A Santos, L Rodrigues, AC Grilo, A Amaral, MC Román Ivorra, JA Castellvi, I Distler, O Spertini, F Müller, R Inanç, M Oksel, F Turkcapar, N Herrick, A Denton, C McHugh, N Chattopadhyay, C Hall, F Buch, M Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study |
title | Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study |
title_full | Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study |
title_fullStr | Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study |
title_full_unstemmed | Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study |
title_short | Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study |
title_sort | nailfold videocapillaroscopic features and other clinical risk factors for digital ulcers in systemic sclerosis: a multicenter, prospective cohort study |
topic | Systemic Sclerosis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129545/ https://www.ncbi.nlm.nih.gov/pubmed/27111549 http://dx.doi.org/10.1002/art.39718 |
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