Cano-García Laura, García-Studer Aimara, Manrique-Arija Sara, Ortiz-Márquez Fernando, Redondo-Rodríguez Rocío, Borregón-Garrido Paula, Mena-Vázquez Natalia, Fernández-Nebro Antonio
Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga 29010, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga 29009, Spain.
Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga 29010, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga 29009, Spain; Departamento de Medicina, Universidad de Málaga, Málaga 29010, Spain.
Semin Arthritis Rheum. 2025 Feb;70:152604. doi: 10.1016/j.semarthrit.2024.152604. Epub 2024 Dec 4.
To determine cumulative organ damage in patients with systemic sclerosis (SSc) according to the Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI), assess 1-year mortality risk, and identify associated factors.
A prospective, single-center study was conducted in a cohort of patients with SSc. A cross-sectional study and a 12-month longitudinal follow-up were carried out. The main outcomes were SCTC-DI and all-cause mortality at 12 months. Other variables included clinical-laboratory data, modified Rodnan Skin Score (mRSS), EuroQoL 5-D (EQ-5D), and Steinbrocker functional status. Multivariate models were used to study factors associated with SCTC-DI and mortality.
The study population comprised 75 patients (97.3% females) with a mean age of 59.6 years. The median (IQR) of the SCTC-DI was 4(6), and only 4 (5.3%) patients had severe SCTC-DI (≥13). The factors associated with SCTC-DI were disease duration (β=0.276), mRSS (β=0.287), C-reactive protein (CRP) concentration (β=0.311), and EQ-5D (β= -0.207). After 1 year of follow-up, 4 patients had died. The factors associated with mortality at 12 months (OR [95% CI]) were baseline SCTC-DI ≥13 (44.5 [1.6-1237.9]; p = 0.025) and visual analog scale (VAS) of the EQ-5D (0.9 [0.8-0.9]; p = 0.018).
The SCTC DI can prove useful in clinical practice for assessing disease progression and short-term mortality risk. Cumulative damage was associated with disease duration, mRSS, CRP concentration, and a decline in EQ-5D, while the risk of death at 12 months was primarily associated with high SCTC-DI and low EQ-5D VAS. New studies are needed to improve assessment tools in patients with SSc.
根据硬皮病临床试验协会损伤指数（SCTC-DI）确定系统性硬化症（SSc）患者的累积器官损伤，评估1年死亡风险，并确定相关因素。
对一组SSc患者进行了一项前瞻性单中心研究。进行了一项横断面研究和为期12个月的纵向随访。主要结局指标为SCTC-DI和12个月时的全因死亡率。其他变量包括临床实验室数据、改良Rodnan皮肤评分（mRSS）、欧洲五维健康量表（EQ-5D）和Steinbrocker功能状态。采用多变量模型研究与SCTC-DI和死亡率相关的因素。
研究人群包括75例患者（97.3%为女性），平均年龄59.6岁。SCTC-DI的中位数（IQR）为4（6），只有4例（5.3%）患者有严重的SCTC-DI（≥13）。与SCTC-DI相关的因素有疾病病程（β=0.276）、mRSS（β=0.287）、C反应蛋白（CRP）浓度（β=0.311）和EQ-5D（β=-0.207）。随访1年后，有4例患者死亡。与12个月时死亡率相关的因素（OR[95%CI]）为基线SCTC-DI≥13（44.5[1.6-1237.9]；p=0.025）和EQ-5D的视觉模拟量表（VAS）（0.9[0.8-0.9]；p=0.018）。
SCTC DI在临床实践中可用于评估疾病进展和短期死亡风险。累积损伤与疾病病程、mRSS、CRP浓度及EQ-5D下降相关，而12个月时的死亡风险主要与高SCTC-DI和低EQ-5D VAS相关。需要开展新的研究以改进SSc患者的评估工具。
