PMID- 31359048
OWN - NLM
STAT- MEDLINE
DCOM- 20200622
LR  - 20200622
IS  - 1462-0332 (Electronic)
IS  - 1462-0324 (Linking)
VI  - 59
IP  - 2
DP  - 2020 Feb 1
TI  - Changes in skin score in early diffuse cutaneous systemic sclerosis are 
      associated with changes in global disease severity.
PG  - 398-406
LID - 10.1093/rheumatology/kez299 [doi]
AB  - OBJECTIVE: To determine whether skin score changes are associated with changes in 
      overall disease severity, function and quality of life in early dcSSc patients. 
      METHODS: A total of 154 and 128 dcSSc patients from the Canadian Scleroderma 
      Research Group database with 1 and 2 year follow-up and a disease duration ⩽5 
      years without end-stage organ damage and/or significant comorbidity at the 
      initial visit were included. Skin was assessed using the modified Rodnan skin 
      score (mRSS) and disease severity by the summed Medsger disease severity score 
      (DSS) (without skin domain), physician and patient global assessments, function 
      [HAQ disability index (HAQ-DI)] and quality of life [36-item Short Form Health 
      Survey (SF-36) physical component summary (PCS)]. Analyses were repeated in 
      patients with a disease duration ⩽3 years. RESULTS: At 2 years, 64 (50%) patients 
      had improved skin (mRSS decrease of ⩾5 points and/or ⩾25%). Skin improvers had 
      improved summed DSS (P = 0.002); better physician global assessments of disease 
      activity, severity and damage (all P ⩽ 0.003); better HAQ-DI (P = 0.001) and 
      SF-36 PCS (P = 0.005). Changes in the mRSS were positively correlated with 
      changes in summed DSS (P = 0.006) and other disease outcomes. In the 26 (20.3%) 
      patients with worsened skin (mRSS increase of ⩾5 points and/or ⩾25%), the summed 
      DSS and physician global assessments were worse (P = 0.01 and P ⩽ 0.009, 
      respectively). In the subgroup with a disease duration ⩽3 years, similar 
      associations were found. CONCLUSION: At 1 and 2 years, overall disease 
      improvement parallels skin improvement in early dcSSc. This is important for 
      prognosis and reflects the value of mRSS as an outcome measure in trials with 
      these patients.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of the 
      British Society for Rheumatology. All rights reserved. For permissions, please 
      email: journals.permissions@oup.com.
FAU - Zheng, Boyang
AU  - Zheng B
AD  - Division of Rheumatology, McGill University, Montreal, QC, Canada.
FAU - Nevskaya, Tatiana
AU  - Nevskaya T
AD  - St Joseph Health Care, London, ON, Canada.
FAU - Baxter, Carl A
AU  - Baxter CA
AD  - MSD Ltd, Hoddesdon, UK.
FAU - Ramey, Dena R
AU  - Ramey DR
AD  - Merck & Co., Inc., Kenilworth, NJ, USA.
FAU - Pope, Janet E
AU  - Pope JE
AD  - St Joseph Health Care, London, ON, Canada.
AD  - Division of Rheumatology, Western University, London, ON, Canada.
FAU - Baron, Murray
AU  - Baron M
AD  - Division of Rheumatology, McGill University, Montreal, QC, Canada.
AD  - Division of Rheumatology, Jewish General Hospital, Montreal, QC, Canada.
CN  - Canadian Scleroderma Research Group
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
SB  - IM
CIN - Rheumatology (Oxford). 2020 Feb 1;59(2):269-270. PMID: 31586429
MH  - Adult
MH  - Disability Evaluation
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Scleroderma, Diffuse/*diagnosis/pathology
MH  - Severity of Illness Index
MH  - Skin/*pathology
OTO - NOTNLM
OT  - disease outcomes
OT  - scleroderma
OT  - skin score
OT  - systemic sclerosis
FIR - Pope, Janet E
IR  - Pope JE
FIR - Baron, Murray
IR  - Baron M
FIR - Hudson, Marie
IR  - Hudson M
FIR - Gyger, Genevieve
IR  - Gyger G
FIR - Larche, Maggie J
IR  - Larche MJ
FIR - Khalidi, Nader A
IR  - Khalidi NA
FIR - Masetto, Ariel
IR  - Masetto A
FIR - Sutton, Evelyn
IR  - Sutton E
FIR - Robinson, David
IR  - Robinson D
FIR - Rodriguez-Reyna, Tatiana S
IR  - Rodriguez-Reyna TS
FIR - Smith, Doug
IR  - Smith D
FIR - Thorne, Carter
IR  - Thorne C
FIR - Fortin, Paul R
IR  - Fortin PR
FIR - Fritzler, Marvin J
IR  - Fritzler MJ
EDAT- 2019/07/31 06:00
MHDA- 2020/06/23 06:00
CRDT- 2019/07/31 06:00
PHST- 2019/03/17 00:00 [received]
PHST- 2019/05/30 00:00 [revised]
PHST- 2019/07/31 06:00 [pubmed]
PHST- 2020/06/23 06:00 [medline]
PHST- 2019/07/31 06:00 [entrez]
AID - 5540356 [pii]
AID - 10.1093/rheumatology/kez299 [doi]
PST - ppublish
SO  - Rheumatology (Oxford). 2020 Feb 1;59(2):398-406. doi: 
      10.1093/rheumatology/kez299.