| Contributors: |
Orlandi, M.; De Luca, G.; Ferri, C.; Spinella, A.; Lumetti, F.; Costantini, R. C.; De Angelis, R.; Riccieri, V.; Bosello, S. L.; Cacciapaglia, F.; Codullo, V.; Bajocchi, G.; Campochiaro, C.; Zanframundo, G.; Foti, R.; Cuomo, G.; Ariani, A.; Rosato, E.; Girelli, F.; Zanatta, E.; Cavazzana, I.; Ingegnoli, F.; De Santis, M.; Murdaca, G.; Abignano, G.; Giorgio, P.; Della Rossa, A.; Caminiti, M.; Iuliano, A. M.; Ciano, G.; Beretta, L.; Bagnato, G.; Lubrano, E.; De Andres, I.; Giollo, A.; Saracco, M.; Agnes, C.; Cipolletta, E.; Magnani, L.; Visalli, E.; Iandoli, C.; Gigante, A.; Pellegrino, G.; Pigatto, E.; Lazzaroni, M. G.; Franceschini, F.; Generali, E.; Mennillo, G.; Barsotti, S.; Mariano, G. P.; Furini, F.; Vultaggio, L.; Parisi, S.; Peroni, C. L.; Bianchi, G.; Fusaro, E.; Sebastiani, G. D.; Govoni, M.; D'Angelo, S.; Cozzi, F.; Guiducci, S.; Doria, A.; Salvarani, C.; Iannone, F.; Dagna, L.; Matucci-Cerinic, M.; Bellando-Randone, S.; Giuggioli, D.; Zanetti, A.; Carrara, G.; Rozza, D.; Landolfi, G.; Scire, C. A.; Talotta, R.; Sambataro, G.; Romeo, N.; Doveri, M.; De Cata, A.; Dall'Ara, F.; Carignola, R.; Calabrese, F.; Benenati, A.; Amato, G. |
| Description: |
Introduction: Digital ulcers (DU) are one of the most frequent manifestations in systemic sclerosis (SSc). The presence of DU seems to be a sentinel sign of internal organ involvement and is related to a poor prognosis of the disease. The aim of this study was to evaluate the prevalence and the relationship of DU with clinical manifestations/variants in a large SSc cohort from the SPRING registry. Methods: SSc patients fulfilling the ACR/EULAR 2013 classification criteria without missing data on digital ulcers were enrolled in a cross-sectional study. Logistic regression models were built to test the association between the presence of DU and SSc-related features. Results: Among 1873 eligible SSc patients, the presence of DU was significantly associated with gastrointestinal involvement (OR 1.88, 2.04 and 1.74; p < 0.001) and serum ATA positivity (OR 2.15; p < 0.001), as well as with telangiectasias, sclerodactyly, digital pitting scar, and calcinosis (OR 1.40, p = 0.005; OR 3.43, p < 0.001, OR 9.12, p < 0.001 and OR 2.77, p < 0.001; respectively). In the multivariable regression models, even after adjustment for covariates, ATA positivity (OR 1.76, p = 0.039), puffy fingers (OR 2.82, p < 0.001), and a higher revEUSTAR-AI (OR 6.63, p < 0.001) emerged as risk factors for the presence of DU. Moreover, a low presence of DU was recorded in SSc patients with a history of previous immunosuppressive treatments (OR 0.53, p = 0.032). Conclusion: In our Italian SSc cohort, DUs were significantly associated with the presence of puffy fingers, high revEUSTR-AI, and ATA seropositivity. Noteworthy, immunosuppressive treatments were associated with a low rate of DU, suggesting that they might contribute to the prevention of these harmful manifestations. (Table presented.) |