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Osteolysis in Systemic Sclerosis: A Scoping Review.

Miguel Gomes Guerra1, Mariana Rodrigues2, Ana Águeda3

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Osteolysis is a significant complication in systemic sclerosis (SSc), yet research is limited. Acro-osteolysis is common, associated with specific SSc subtypes and antibodies, but predictors and treatments remain understudied.

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Area of Science:

  • Rheumatology
  • Dermatology
  • Radiology

Background:

  • Osteolysis, a bone resorption condition, significantly impacts patients with systemic sclerosis (SSc).
  • Existing literature presents heterogeneity in osteolysis detection and reporting within SSc patient cohorts.
  • Acro-osteolysis (AO) is the most prevalent form, frequently observed in SSc.

Purpose of the Study:

  • To conduct a scoping review on osteolysis in systemic sclerosis (SSc).
  • To identify current research trends, knowledge gaps, and clinical implications of osteolysis in SSc.

Main Methods:

  • Systematic literature search adhering to PRISMA-ScR guidelines.
  • Inclusion of 29 articles from 351 identified results.
  • Analysis of study characteristics, osteolysis prevalence, locations, associated factors, and detection methods.

Main Results:

  • Heterogeneity in study populations, inclusion criteria, and osteolysis detection methods were noted.
  • Acro-osteolysis (AO) was the most frequent finding, positively correlated with diffuse cutaneous SSc and anti-topoisomerase I antibodies.
  • Digital ischemia and calcinosis were significant predictors of AO, while ultrasound demonstrated high detection sensitivity.

Conclusions:

  • A significant research gap exists regarding osteolysis in SSc, particularly concerning predictors and prognostic value.
  • No studies addressing treatment strategies for osteolysis in SSc were identified.
  • Further longitudinal studies are needed to establish reliable prognostic markers and treatment guidelines for osteolysis in SSc.