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Treatment outcome i...
Treatment outcome in early diffuse cutaneous systemic sclerosis : The European Scleroderma Observational Study (ESOS)
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- Herrick, Ariane L (author)
- Great Ormond Street Hospital,University of Manchester
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- Pan, Xiaoyan (author)
- University of Manchester
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- Peytrignet, Sébastien (author)
- University of Manchester
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- Lunt, Mark (author)
- University of Manchester
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- Hesselstrand, Roger (author)
- 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 Group
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- Mouthon, Luc (author)
- Paris Descartes University
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- Silman, Alan (author)
- University of Oxford
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- Brown, Edith (author)
- University of Manchester
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- Czirják, László (author)
- University of Pécs
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- Distler, Jörg H W (author)
- Friedrich-Alexander University Erlangen-Nürnberg
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- Distler, Oliver (author)
- University of Zurich
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- Fligelstone, Kim (author)
- Great Ormond Street Hospital
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- Gregory, William J. (author)
- Great Ormond Street Hospital
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- Ochiel, Rachel (author)
- Great Ormond Street Hospital
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- Vonk, Madelon (author)
- Radboud University Nijmegen
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- Ancuta, Codrina (author)
- Grigore T. Popa University of Medicine and Pharmacy
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- Ong, Voon H. (author)
- University College London
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- Farge, Dominique (author)
- Institut Gustave Roussy
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- Hudson, Marie (author)
- McGill University
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- Matucci-Cerinic, Marco (author)
- University of Florence
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- Balbir-Gurman, Alexandra (author)
- Technion - Israel Institute of Technology
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- Midtvedt, Øyvind (author)
- Norwegian Radium Hospital
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- Jordan, Alison C. (author)
- New Queen Elizabeth Hospital
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- Jobanputra, Paresh (author)
- New Queen Elizabeth Hospital
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- Stevens, Wendy (author)
- St. Vincent's Hospital, Melbourne
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- Moinzadeh, Pia (author)
- University of Cologne
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- Hall, Frances C. (author)
- University of Cambridge
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- Agard, Christian (author)
- University of Nantes
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- Anderson, Marina E. (author)
- University of Liverpool
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- Diot, Elisabeth (author)
- Hopital Bretonneau
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- Madhok, Rajan (author)
- Glasgow Royal Infirmary
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- Akil, Mohammed (author)
- Sheffield Teaching Hospitals
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- Buch, Maya H (author)
- University of Leeds
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- Chung, Lorinda (author)
- Stanford University
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- Damjanov, Nemanja (author)
- University of Belgrade
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- Gunawardena, Harsha (author)
- North Bristol NHS Trust
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- Lanyon, Peter (author)
- Nottingham University Hospitals NHS Trust
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- Ahmad, Yasmeen (author)
- Peter Maddison Rheumatology Centre
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- Chakravarty, Kuntal (author)
- Queen’s Hospital
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- Jacobsen, Søren (author)
- University of Copenhagen
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- MacGregor, Alexander J. (author)
- University of East Anglia
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- McHugh, Neil (author)
- Royal National Hospital for Rheumatic Diseases
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- Müller-Ladner, Ulf (author)
- Justus Liebig University Giessen
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- Riemekasten, Gabriela (author)
- British Columbia Children's Hospital
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- Becker, Michael (author)
- Charité - University Medicine Berlin
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- Roddy, Janet (author)
- Royal Perth Hospital
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- Carreira, Patricia E. (author)
- 12 de Octubre University Hospital
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- Fauchais, Anne-Laure (author)
- University Hospital Of Limoges
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- Hachulla, Eric (author)
- University of Lille
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- Hamilton, Jennifer (author)
- Gateshead Hospitals Foundation Trust
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- Inanç, Murat (author)
- Istanbul University
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- McLaren, John S. (author)
- Whyteman's Brae Hospital
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- van Laar, Jacob M. (author)
- University Medical Center Utrecht
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- Pathare, Sanjay (author)
- James Cook University Hospital
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- Proudman, Susannah (author)
- University of Adelaide
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- Rudin, Anna, 1961 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research
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- Sahhar, Joanne (author)
- Monash University
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- Coppere, Brigitte (author)
- Hôpital Edouard Herriot
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- Serratrice, Christine (author)
- Hospital Saint Joseph
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- Sheeran, Tom (author)
- Cannock Chase Hospital
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- Veale, Douglas J. (author)
- St Vincent's University Hospital
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- Grange, Claire (author)
- Centre Hospitalier Lyon Sud
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- Trad, Georges Selim (author)
- CHU Ambroise Paré
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- Denton, Christopher P (author)
- University College London
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(creator_code:org_t)
- 2017-02-10
- 2017
- English 12 s.
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In: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 76:7, s. 1207-1218
- Related links:
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http://dx.doi.org/10...
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https://ard.bmj.com/...
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https://lup.lub.lu.s...
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Abstract
Subject headings
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- Cyclophosphamide
- Methotrexate
- Systemic Sclerosis
- Treatment
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Herrick, Ariane ...
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Pan, Xiaoyan
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Peytrignet, Séba ...
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Lunt, Mark
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Hesselstrand, Ro ...
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Mouthon, Luc
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show more...
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Silman, Alan
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Brown, Edith
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Czirják, László
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Distler, Jörg H ...
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Distler, Oliver
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Fligelstone, Kim
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Gregory, William ...
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Ochiel, Rachel
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Vonk, Madelon
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Ancuta, Codrina
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Ong, Voon H.
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Farge, Dominique
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Hudson, Marie
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Matucci-Cerinic, ...
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Balbir-Gurman, A ...
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Midtvedt, Øyvind
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Jordan, Alison C ...
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Jobanputra, Pare ...
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Stevens, Wendy
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Moinzadeh, Pia
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Hall, Frances C.
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Agard, Christian
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Anderson, Marina ...
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Diot, Elisabeth
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Madhok, Rajan
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Akil, Mohammed
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Buch, Maya H
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Chung, Lorinda
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Damjanov, Nemanj ...
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Gunawardena, Har ...
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Lanyon, Peter
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Ahmad, Yasmeen
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Chakravarty, Kun ...
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Jacobsen, Søren
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MacGregor, Alexa ...
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McHugh, Neil
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Müller-Ladner, U ...
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Riemekasten, Gab ...
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Becker, Michael
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Roddy, Janet
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Carreira, Patric ...
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Fauchais, Anne-L ...
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Hachulla, Eric
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Hamilton, Jennif ...
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Inanç, Murat
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McLaren, John S.
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van Laar, Jacob ...
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Pathare, Sanjay
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Proudman, Susann ...
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Rudin, Anna, 196 ...
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Sahhar, Joanne
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Coppere, Brigitt ...
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Serratrice, Chri ...
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Sheeran, Tom
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Veale, Douglas J ...
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Grange, Claire
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Trad, Georges Se ...
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Denton, Christop ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
- Articles in the publication
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Annals of the Rh ...
- By the university
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Lund University
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University of Gothenburg