Calcinosis in Rheumatic Disease Is Still an Unmet Need: A Retrospective Single-Center Study

Area of Science:

• Rheumatology
• Dermatology
• Internal Medicine

Background:

• Calcinosis is an under-recognized manifestation in immune-mediated rheumatic diseases (IMRD).
• It often presents years after disease onset and is incorrectly perceived as non-lethal.
• Early identification is key to preventing disease progression.

Purpose of the Study:

• To investigate the prevalence, clinical associations, and survival impact of subcutaneous calcinosis in IMRD patients.
• To analyze the characteristics of calcinosis in systemic sclerosis (SSc).
• To evaluate current treatment outcomes for calcinosis.

Main Methods:

• Single-center retrospective study.
• Inclusion of 86 patients with IMRD and subcutaneous calcinosis.
• Analysis of calcinosis lesion size, clinical associations, and survival data.

Main Results:

• Calcinosis occurred in 74% of patients with longstanding disease, particularly SSc.
• Smaller lesions (≤1 cm) correlated with interstitial lung disease, musculoskeletal issues, and digital ulcers.
• Larger lesions (≥4 cm) were linked to malignancy, severe peripheral artery disease, and hypertension.
• SSc patients with calcinosis had higher disease activity scores.
• No significant difference in survival rates was observed between calcinosis and non-calcinosis groups.
• Diltiazem was common; bisphosphonates reduced complications but did not resolve calcinosis.

Conclusions:

• Calcinosis is prevalent in IMRD, especially SSc, and associated with specific comorbidities based on lesion size.
• Current diagnostic, monitoring, and treatment strategies for calcinosis are limited.
• Further research and improved therapies are essential for better patient outcomes in IMRD-related calcinosis.