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Clin Exp Rheumatol. 2019 May 30. [Epub ahead of print]

Correlation between capillaroscopic classifications and severity in systemic sclerosis: results from SCLEROCAP study at inclusion.

Author information

1
Service de Médecine Vasculaire, Hôpital Saint-André, Bordeaux, France.
2
Unité de Soutien Méthodologique à la Recherche Clinique, Pôle de Santé Publique, CHU de Bordeaux, France.
3
Hôpital Universitaire de Grenoble, Département de Médecine Vasculaire, Grenoble, France.
4
Service de Médecine Interne, Hôpital de la Pitié, Paris, France.
5
Service de Dérmatologie, Médecine Vasculaire et Allergologie, Hôpital Tenon, Paris, France.
6
Service de Médecine Vasculaire, Hôpital Saint-Joseph, Paris, France.
7
Service de Médecine Vasculaire, Hôpital Rangueil, Toulouse, France.
8
Service de Médecine Vasculaire, Limoges, France.
9
Service de Rhumatologie, Hôpital Pellegrin, Bordeaux, France.
10
Service de Dermatologie, Hôpital Saint-André, Bordeaux, France.
11
Service de Médecine Interne, Clinique Mutualiste de Lesparre, France.
12
Service de Médecine Interne et Maladies Infectieuses, Hôpital Haut-Lévêque, Pessac, France.
13
Service de Médecine Vasculaire, Hôpital Saint Eloi, Montpellier, France.
14
Service de Médecine Vasculaire, Hôtel Dieu, Nantes, France.
15
Service de Médecine Vasculaire, CHU Nord Saint-Etienne, Université Jean Monnet, Campus Santé et Innovations, Saint-Etienne, France.
16
Service de Médecine Vasculaire, Hôpital Saint-André, Bordeaux, France. joelconstans@gmail.com.

Abstract

OBJECTIVES:

We assessed the correlation between severity of systemic sclerosis (SSc) and current staging systems based on nailfold capillaroscopy.

METHODS:

SCLEROCAP is a multicenter prospective study including consecutive scleroderma patients who have a yearly routine follow-up with capillaroscopy and digital blood pressure measurement. Capillaroscopy images were read by two observers blinded from each other, then by a third one in the case of discordance. A follow-up of 3 years is planned. The present study assessed the correlation between severity of systemic sclerosis (SSc) and current staging systems based on nail fold capillaroscopy at enrollment in the SCLEROCAP study. Univariate and multivariate logistic regression analysis was performed for both the Maricq and Cutolo classifications.

RESULTS:

SCLEROCAP included 387 patients in one year. Maricq's active and Cutolo's late classifications were very similar. In multivariate analysis, the number of digital ulcers (OR for 2 ulcers or more, respectively 2.023 [1.074-3.81] and 2.596 [1.434-4.699]) and Rodnan's skin score >15 (OR respectively 32.007 [6.457-158.658] and 18.390 [5.380-62.865]) correlated with Maricq's active and Cutolo's late stages. Haemoglobin rate correlated with Cutolo's late stage (hemoglobin<100 vs. >120 g/dl: OR 0.223 [0.051-0.980]), and total lung capacity with Maricq's active one: increase in 10%: OR0.833 [0.717-0.969].

CONCLUSIONS:

The correlations found between capillaroscopy and severity of SSc are promising before the ongoing prospective study definitively assesses whether capillaroscopy staging predicts complications of SSc. Only two capillaroscopic patterns seem useful: one involving many giant capillaries and haemorrhages and the other with severe capillary loss.

PMID:
31172926

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