Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study

Gianfranco Ferraccioli, Maurizio Cutolo, Ariane L. Herrick, Oliver Distler, Mike O. Becker, Emma Beltran, Patrick Carpentier, Clodoveo Ferri, Murat Inanç, Panayiotis Vlachoyiannopoulos, Harbajan Chadha-Boreham, Emmanuelle Cottreel, Thomas Pfister, Daniel Rosenberg, Juan V. Torres, Vanessa Smith

Risultato della ricerca: Contributo in rivistaArticolo in rivista

81 Citazioni (Scopus)

Abstract

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.
Lingua originaleEnglish
pagine (da-a)2527-2539
Numero di pagine13
RivistaARTHRITIS & RHEUMATOLOGY
Volume68
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Immunology
  • Immunology and Allergy
  • Rheumatology

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