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Article Dans Une Revue Arthritis Research & Therapy Année : 2020

Early trajectories of skin thickening are associated with severity and mortality in systemic sclerosis

Emmanuel Ledoult
  • Fonction : Auteur
David Launay
  • Fonction : Auteur
Hélène Béhal
  • Fonction : Auteur
Luc Mouthon
  • Fonction : Auteur
Grégory Pugnet
  • Fonction : Auteur
Christian Agard
  • Fonction : Auteur
Yannick Allanore
  • Fonction : Auteur
Patrick Jego
  • Fonction : Auteur
Anne-Laure Fauchais
  • Fonction : Auteur
Jean-Robert Harlé
  • Fonction : Auteur
Sabine Berthier
  • Fonction : Auteur
Achille Aouba
  • Fonction : Auteur
Arsène Mekinian
  • Fonction : Auteur
Elisabeth Diot
  • Fonction : Auteur
Marie-Elise Truchetet
  • Fonction : Auteur
Carine Boulon
  • Fonction : Auteur
Alain Duhamel
  • Fonction : Auteur
Eric Hachulla
  • Fonction : Auteur
Vincent Sobanski

Résumé

Abstract Background Systemic sclerosis (SSc) is a severe and highly heterogeneous disease. The modified Rodnan skin score (mRSS) is a widely used tool for the assessment of the extent and degree of skin thickness. This study aimed to identify the classes of patients with early similar skin thickening trajectories without any a priori assumptions and study their associations with organ involvement and survival. Methods From the French SSc national cohort, patients with a disease duration of less than 2 years at inclusion and with at least 2 mRSS available within the first 4 years of follow-up were enrolled. Classes of patients with similar mRSS trajectories were identified based on a latent class mixed model. The clinical characteristics and survival rate were compared between the obtained classes. Results A total of 198 patients fulfilled the inclusion criteria, with a total of 641 mRSS available. The median disease duration and follow-up were 0.8 (interquartile range 0.4; 1.2) and 6.3 (3.8; 8.9) years, respectively. Individual trajectories of mRSS were highly heterogeneous between patients. Models with 1–6 latent classes of trajectories were sequentially assessed, and the 5-class model represented the best fit to data. Each class was characterized by a unique global trajectory of mRSS. The median disease duration did not differ significantly between classes. Baseline organ involvement was more frequent in classes with significant change over time (classes 2–5) than in class 1 (low baseline mRSS without significant change over time). Using Cox regression, we observed a progressively increasing risk of death from classes 1 to 5. Conclusions Early identification of clinical phenotype based on skin thickening trajectories could predict morbi-mortality in SSc. This study suggested that mRSS trajectories characterization might be pivotal for clinical practice and future trial designs.

Dates et versions

hal-04629123 , version 1 (28-06-2024)

Identifiants

Citer

Emmanuel Ledoult, David Launay, Hélène Béhal, Luc Mouthon, Grégory Pugnet, et al.. Early trajectories of skin thickening are associated with severity and mortality in systemic sclerosis. Arthritis Research & Therapy, 2020, 22 (1), pp.30. ⟨10.1186/s13075-020-2113-6⟩. ⟨hal-04629123⟩
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