Treatment outcome in early diffuse cutaneous systemic sclerosis : The European Scleroderma Observational Study (ESOS)

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Fältnamn	Indikatorer	Metadata
000		08478naa a2201153 4500
001		oai:lup.lub.lu.se:c78f40d0-0b38-43bf-b220-76e05526147b
003		SwePub
008		170809s2017 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:gup.ub.gu.se/252021
024	7	a https://lup.lub.lu.se/record/c78f40d0-0b38-43bf-b220-76e05526147b2 URI
024	7	a https://doi.org/10.1136/annrheumdis-2016-2105032 DOI
024	7	a https://gup.ub.gu.se/publication/2520212 URI
040		a (SwePub)lud (SwePub)gu
041		a engb eng
042		9 SwePub
072	7	a art2 swepub-publicationtype
072	7	a ref2 swepub-contenttype
100	1	a Herrick, Ariane Lu Great Ormond Street Hospital,University of Manchester4 aut
245	1 0	a Treatment outcome in early diffuse cutaneous systemic sclerosis : The European Scleroderma Observational Study (ESOS)
264		c 2017-02-10
264	1	b BMJ,c 2017
300		a 12 s.
520		a Objectives: The rarity of early diffuse cutaneous systemic sclerosis (dcSSc) makes randomised controlled trials very difficult. We aimed to use an observational approach to compare effectiveness of currently used treatment approaches. Methods: This was a prospective, observational cohort study of early dcSSc (within three years of onset of skin thickening). Clinicians selected one of four protocols for each patient: methotrexate, mycophenolate mofetil (MMF), cyclophosphamide or 'no immunosuppressant'. Patients were assessed three-monthly for up to 24 months. The primary outcome was the change in modified Rodnan skin score (mRSS). Confounding by indication at baseline was accounted for using inverse probability of treatment (IPT) weights. As a secondary outcome, an IPT-weighted Cox model was used to test for differences in survival. Results Of 326 patients recruited from 50 centres, 65 were prescribed methotrexate, 118 MMF, 87 cyclophosphamide and 56 no immunosuppressant. 276 (84.7%) patients completed 12 and 234 (71.7%) 24 months follow-up (or reached last visit date). There were statistically significant reductions in mRSS at 12 months in all groups: -4.0 (-5.2 to -2.7) units for methotrexate, -4.1 (-5.3 to -2.9) for MMF, -3.3 (-4.9 to -1.7) for cyclophosphamide and -2.2 (-4.0 to -0.3) for no immunosuppressant (p value for between-group differences=0.346). There were no statistically significant differences in survival between protocols before (p=0.389) or after weighting (p=0.440), but survival was poorest in the no immunosuppressant group (84.0%) at 24 months. Conclusions: These findings may support using immunosuppressants for early dcSSc but suggest that overall benefit is modest over 12 months and that better treatments are needed.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reumatologi och inflammation0 (SwePub)302102 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Rheumatology and Autoimmunity0 (SwePub)302102 hsv//eng
653		a Cyclophosphamide
653		a Methotrexate
653		a Systemic Sclerosis
653		a Treatment
700	1	a Pan, Xiaoyanu University of Manchester4 aut
700	1	a Peytrignet, Sébastienu University of Manchester4 aut
700	1	a Lunt, Marku University of Manchester4 aut
700	1	a Hesselstrand, Rogeru Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt-lungsjukdom - information, stöd och bemötande,Forskargrupper vid Lunds universitet,Forskargruppen för systemisk skleros, Lund,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Cardiopulmonary disease - information, support and reception,Lund University Research Groups,Lund Systemic Sclerosis Research Group4 aut0 (Swepub:lu)reum-rhe
700	1	a Mouthon, Lucu Paris Descartes University4 aut
700	1	a Silman, Alanu University of Oxford4 aut
700	1	a Brown, Edithu University of Manchester4 aut
700	1	a Czirják, Lászlóu University of Pécs4 aut
700	1	a Distler, Jörg H Wu Friedrich-Alexander University Erlangen-Nürnberg4 aut
700	1	a Distler, Oliveru University of Zurich4 aut
700	1	a Fligelstone, Kimu Great Ormond Street Hospital4 aut
700	1	a Gregory, William J.u Great Ormond Street Hospital4 aut
700	1	a Ochiel, Rachelu Great Ormond Street Hospital4 aut
700	1	a Vonk, Madelonu Radboud University Nijmegen4 aut
700	1	a Ancuta, Codrinau Grigore T. Popa University of Medicine and Pharmacy4 aut
700	1	a Ong, Voon H.u University College London4 aut
700	1	a Farge, Dominiqueu Institut Gustave Roussy4 aut
700	1	a Hudson, Marieu McGill University4 aut
700	1	a Matucci-Cerinic, Marcou University of Florence4 aut
700	1	a Balbir-Gurman, Alexandrau Technion - Israel Institute of Technology4 aut
700	1	a Midtvedt, Øyvindu Norwegian Radium Hospital4 aut
700	1	a Jordan, Alison C.u New Queen Elizabeth Hospital4 aut
700	1	a Jobanputra, Pareshu New Queen Elizabeth Hospital4 aut
700	1	a Stevens, Wendyu St. Vincent's Hospital, Melbourne4 aut
700	1	a Moinzadeh, Piau University of Cologne4 aut
700	1	a Hall, Frances C.u University of Cambridge4 aut
700	1	a Agard, Christianu University of Nantes4 aut
700	1	a Anderson, Marina E.u University of Liverpool4 aut
700	1	a Diot, Elisabethu Hopital Bretonneau4 aut
700	1	a Madhok, Rajanu Glasgow Royal Infirmary4 aut
700	1	a Akil, Mohammedu Sheffield Teaching Hospitals4 aut
700	1	a Buch, Maya Hu University of Leeds4 aut
700	1	a Chung, Lorindau Stanford University4 aut
700	1	a Damjanov, Nemanjau University of Belgrade4 aut
700	1	a Gunawardena, Harshau North Bristol NHS Trust4 aut
700	1	a Lanyon, Peteru Nottingham University Hospitals NHS Trust4 aut
700	1	a Ahmad, Yasmeenu Peter Maddison Rheumatology Centre4 aut
700	1	a Chakravarty, Kuntalu Queen’s Hospital4 aut
700	1	a Jacobsen, Sørenu University of Copenhagen4 aut
700	1	a MacGregor, Alexander J.u University of East Anglia4 aut
700	1	a McHugh, Neilu Royal National Hospital for Rheumatic Diseases4 aut
700	1	a Müller-Ladner, Ulfu Justus Liebig University Giessen4 aut
700	1	a Riemekasten, Gabrielau British Columbia Children's Hospital4 aut
700	1	a Becker, Michaelu Charité - University Medicine Berlin4 aut
700	1	a Roddy, Janetu Royal Perth Hospital4 aut
700	1	a Carreira, Patricia E.u 12 de Octubre University Hospital4 aut
700	1	a Fauchais, Anne-Laureu University Hospital Of Limoges4 aut
700	1	a Hachulla, Ericu University of Lille4 aut
700	1	a Hamilton, Jenniferu Gateshead Hospitals Foundation Trust4 aut
700	1	a Inanç, Muratu Istanbul University4 aut
700	1	a McLaren, John S.u Whyteman's Brae Hospital4 aut
700	1	a van Laar, Jacob M.u University Medical Center Utrecht4 aut
700	1	a Pathare, Sanjayu James Cook University Hospital4 aut
700	1	a Proudman, Susannahu University of Adelaide4 aut
700	1	a Rudin, Anna,d 1961u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research4 aut0 (Swepub:gu)xrudan
700	1	a Sahhar, Joanneu Monash University4 aut
700	1	a Coppere, Brigitteu Hôpital Edouard Herriot4 aut
700	1	a Serratrice, Christineu Hospital Saint Joseph4 aut
700	1	a Sheeran, Tomu Cannock Chase Hospital4 aut
700	1	a Veale, Douglas J.u St Vincent's University Hospital4 aut
700	1	a Grange, Claireu Centre Hospitalier Lyon Sud4 aut
700	1	a Trad, Georges Selimu CHU Ambroise Paré4 aut
700	1	a Denton, Christopher Pu University College London4 aut
710	2	a Great Ormond Street Hospitalb University of Manchester4 org
773	0	t Annals of the Rheumatic Diseasesd : BMJg 76:7, s. 1207-1218q 76:7<1207-1218x 0003-4967x 1468-2060
856	4	u http://dx.doi.org/10.1136/annrheumdis-2016-210503y FULLTEXT
856	4	u https://ard.bmj.com/content/annrheumdis/76/7/1207.full.pdf
856	4 8	u https://lup.lub.lu.se/record/c78f40d0-0b38-43bf-b220-76e05526147b
856	4 8	u https://doi.org/10.1136/annrheumdis-2016-210503
856	4 8	u https://gup.ub.gu.se/publication/252021

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Av författaren/redakt...: Herrick, Ariane ...; Pan, Xiaoyan; Peytrignet, Séba ...; Lunt, Mark; Hesselstrand, Ro ...; Mouthon, Luc; visa fler...; Silman, Alan; Brown, Edith; Czirják, László; Distler, Jörg H ...; Distler, Oliver; Fligelstone, Kim; Gregory, William ...; Ochiel, Rachel; Vonk, Madelon; Ancuta, Codrina; Ong, Voon H.; Farge, Dominique; Hudson, Marie; Matucci-Cerinic, ...; Balbir-Gurman, A ...; Midtvedt, Øyvind; Jordan, Alison C ...; Jobanputra, Pare ...; Stevens, Wendy; Moinzadeh, Pia; Hall, Frances C.; Agard, Christian; Anderson, Marina ...; Diot, Elisabeth; Madhok, Rajan; Akil, Mohammed; Buch, Maya H; Chung, Lorinda; Damjanov, Nemanj ...; Gunawardena, Har ...; Lanyon, Peter; Ahmad, Yasmeen; Chakravarty, Kun ...; Jacobsen, Søren; MacGregor, Alexa ...; McHugh, Neil; Müller-Ladner, U ...; Riemekasten, Gab ...; Becker, Michael; Roddy, Janet; Carreira, Patric ...; Fauchais, Anne-L ...; Hachulla, Eric; Hamilton, Jennif ...; Inanç, Murat; McLaren, John S.; van Laar, Jacob ...; Pathare, Sanjay; Proudman, Susann ...; Rudin, Anna, 196 ...; Sahhar, Joanne; Coppere, Brigitt ...; Serratrice, Chri ...; Sheeran, Tom; Veale, Douglas J ...; Grange, Claire; Trad, Georges Se ...; Denton, Christop ...; visa färre...

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