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Do We Have Good Activity Indices in Systemic Sclerosis?

Laura Groseanu1,2, Sorana Petrescu1,3, Andra Balanescu1,2

  • 1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Current Rheumatology Reviews
|September 14, 2021
PubMed
Summary

Systemic sclerosis disease activity indices like EScSG AI and r-EUSTAR AI can predict organ damage, aiding clinical practice. While no gold standard exists, these tools help manage patient outcomes and monitor disease progression.

Keywords:
12point AICRISSEScSG AISScSystemic Sclerosisr-EUSTAR AI

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Area of Science:

  • Rheumatology
  • Immunology
  • Internal Medicine

Background:

  • No fully validated index currently exists for assessing overall disease activity in systemic sclerosis (SSc).
  • Accurate assessment of SSc disease activity is crucial for predicting organ damage and guiding treatment.

Purpose of the Study:

  • To evaluate the predictive value of different disease activity indices for subsequent organ damage in systemic sclerosis.
  • To compare the efficacy of European Systemic sclerosis study group activity index (EScSG AI), r-EUSTAR AI, and 12-point AI in predicting SSc progression.

Main Methods:

  • Calculated EScSG AI, r-EUSTAR AI, and 12-point AI for 91 SSc patients.
  • Utilized logistic regression and other statistical tests to analyze the relationship between disease activity indices and organ damage markers.
  • Included CRISS for patients diagnosed after 2016.

Main Results:

  • EScSG AI, r-EUSTAR AI, and 12-point AI correlated with lung involvement, skin involvement, digital ulcers, and renal crisis.
  • Disease activity scores inversely correlated with FVC and DLCO, and positively with pulmonary fibrosis, mRSS, HAQ, sPAP, CRP, and capillaroscopy scores.
  • EScSG AI and 12-point AI predicted worse skin involvement; EScSG AI predicted decreasing DLCO; 12-point AI predicted declining FVC and higher HAQ scores; r-EUSTAR AI predicted muscular deterioration and FVC/DLCO worsening.

Conclusions:

  • While no gold standard was established, EScSG AI and r-EUSTAR AI effectively quantify and predict major organ involvement in SSc clinical practice.
  • CRISS is a valuable outcome measure for SSc patients with short disease duration in clinical studies.
  • These validated indices offer significant potential for monitoring SSc progression and informing patient management.