Damage Trajectories in Systemic Sclerosis Using Group‐Based Trajectory Modeling Academic Article uri icon

  •  
  • Overview
  •  
  • Research
  •  
  • Identity
  •  
  • Additional Document Info
  •  
  • View All
  •  

abstract

  • Objective

    Systemic sclerosis (SSc) is an autoimmune disease characterized by progressive organ damage, which can be measured using the Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI). We aimed to identify whether distinct trajectories of damage accrual exist and to determine which variables are associated with different trajectory groups.

    Methods

    Incident cases of SSc (<2 years) were identified in the Australian Scleroderma Interest Group and Canadian Scleroderma Research Group prospective registries. Group-based trajectory modeling was used to identify SCTC-DI trajectories over the cohort's first 5 annual visits. Baseline variables associated with trajectory membership in a univariate analysis were examined in multivariable models.

    Results

    A total of 410 patients were included. Three trajectory groups were identified: low (54.6%), medium (36.2%), and high (10.3%) damage. Patients with faster damage accrual had higher baseline SCTC-DI scores. Older age (odds ratio [OR] 1.57 [95% confidence interval (95% CI) 1.18-2.10]), male sex (OR 2.55 [95% CI 1.10-5.88]), diffuse disease (OR 6.7 [95% CI 2.57-17.48]), tendon friction rubs (OR 5.4 [95% CI 1.86-15.66]), and elevated C-reactive protein level (OR 1.98 [95% CI 1.49-2.63]) increased the odds of being in the high-damage group versus the reference (low damage), whereas White ethnicity (OR 0.31 [95% CI 0.12-0.75]) and anticentromere antibodies (OR 0.24 [95% CI 0.07-0.77]) decreased the odds.

    Conclusion

    We identified 3 trajectories of damage accrual in a combined incident SSc cohort. Several characteristics increased the odds of belonging to worse trajectories. These findings may be helpful in recognizing patients in whom early aggressive treatment is necessary.

authors

  • Barbacki, Ariane
  • Baron, Murray
  • Wang, Mianbo
  • Zhang, Yuqing
  • Stevens, Wendy
  • Sahhar, Joanne
  • Proudman, Susanna
  • Nikpour, Mandana
  • Man, Ada
  • Baron, M
  • Hudson, M
  • Gyger, G
  • Hoa, S
  • Pope, J
  • Larche, Margaret
  • Khalidi, Nader
  • Massetto, A
  • Sutton, E
  • Rodriguez‐Reyna, TS
  • Maltez, N
  • Thorne, C
  • Fortin, PR
  • Iki, A
  • Robinson, D
  • Jones, N
  • LeClercq, S
  • Docherty, P
  • Smith, D
  • Fritzler, M
  • Nikpour, Mandana
  • Proudman, Susanna
  • Stevens, Wendy
  • Sahhar, Joanne
  • Ferdowsi, Nava
  • Morrisroe, Kathleen
  • Ross, Laura
  • Ngian, Gene‐Siew
  • Walker, Jennifer
  • Roddy, Janet
  • Host, Lauren
  • Major, Gabor

publication date

  • March 2023