Improvement in skin thickening in systemic sclerosis associated with improved survival

Steen, Virginia D.; Medsger, Thomas A.

doi:10.1002/1529-0131(200112)44:12<2828::aid-art470>3.0.co;2-u

Cited by 207 publications

(137 citation statements)

References 15 publications

Supporting

Mentioning

128

Contrasting

Unclassified

Order By: Relevance

“…This challenges the feasibility of a "prevention of worsening" study design despite the success of this trial in targeting and enrolling an early disease cohort. It suggests that improvement in skin involvement is not confined to late-stage disease (32).…”

Section: Discussionmentioning

confidence: 99%

Recombinant human anti–transforming growth factor β1 antibody therapy in systemic sclerosis: A multicenter, randomized, placebo‐controlled phase I/II trial of CAT‐192

Denton

Merkel

Fürst

et al. 2007

Arthritis & Rheumatism

424

261

View full text Add to dashboard Cite

Results. Forty-five patients were enrolled. There was significant morbidity and mortality, including 1 death in the group receiving 0.5 mg/kg of CAT-192 and 3 deaths in the group receiving 5 mg/kg of CAT-192. There were more adverse events and more serious adverse events in patients receiving CAT-192 than in those receiving placebo, although these events were not more frequent in the high-dose treatment group. The MRSS improved in all groups during the study, but there was no evidence of a treatment effect for CAT-192. Improvement in the MRSS correlated with the disease duration (r ‫؍‬ ؊0.54, P ‫؍‬ 0.0008). Changes in the PINP level from baseline correlated with changes in the MRSS (r ‫؍‬ 0.37, P ‫؍‬ 0.027).Conclusion. We report the first evaluation of a systemically administered and repeatedly dosed anti-TGF␤1 drug. In this pilot study, CAT-192, in doses up to 10 mg/kg, showed no evidence of efficacy. The utility of

show abstract

Section: Discussionmentioning

confidence: 99%

Recombinant human anti–transforming growth factor β1 antibody therapy in systemic sclerosis: A multicenter, randomized, placebo‐controlled phase I/II trial of CAT‐192

Denton

Merkel

Fürst

et al. 2007

Arthritis & Rheumatism

424

261

View full text Add to dashboard Cite

show abstract

“…Our study population had a shorter duration of disease at baseline compared with previous registry-based cohorts (5). Although the retrospective study design has the advantage of maximizing subject inclusion and favors a short duration of disease at the time of entry, it does not permit a formal comparison of therapies.…”

Section: Discussionmentioning

confidence: 99%

“…The initial analysis of the study cohort was partially funded by an unrestricted research grant to Dr. Denton from Genzyme Corporation. 1 Lynne Shand, MRCP, Svetlana Nihtyanova, MBBS, Manscore of at least 25% between baseline and the 2-year followup assessment had a 5-year survival of 90%, compared with 77% survival among "nonimprovers" (5). The MRSS therefore represents a surrogate marker of disease severity in patients with dcSSc and, as such, has been suggested as a useful clinical trial outcome.…”

mentioning

confidence: 99%

Relationship between change in skin score and disease outcome in diffuse cutaneous systemic sclerosis: Application of a latent linear trajectory model

Shand

Lunt

Nihtyanova

et al. 2007

Arthritis & Rheumatism

171

111

View full text Add to dashboard Cite

Objective. To explore the relationship between changes in the severity of skin disease and morbidity and mortality in patients with diffuse cutaneous systemic sclerosis (dcSSc).Methods. From a large single-center cohort, we identified 225 patients with dcSSc for whom serial clinical information was available from within 24 months of the onset of the first non-Raynaud's phenomenon manifestation of SSc. The end points analyzed included death and heart, lung, kidney, and gastrointestinal tract involvement. Latent linear trajectory modeling (LTM) was applied to identify patients with a similar trajectory of modified Rodnan skin thickness score (MRSS) changes over the first 3 years of followup. Clinical outcomes were compared between 3 different LTM subgroups.Results. LTM permitted classification of 131 patients (58%) into 1 of 3 subgroups with different skin score trajectories. Survival was lowest in the subgroup of patients who had a high baseline skin score and experienced little improvement during followup (P ‫؍‬ 0.003). However, the frequency of clinical end points was similar in the subgroup with the most favorable trajectory (i.e., a low initial MRSS and subsequent improvement) and the subgroup with a high baseline MRSS and no improvement. Interestingly, the end point frequency was greatest in the subgroup with a high initial MRSS and subsequent improvement, suggesting that sustained severe skin disease does not necessarily predict the number of visceral complications, and that the relationship between the skin score and internal organ involvement in dcSSc is more complex than previously thought.Conclusion. Although mortality was highest among patients with the worst skin-related outcomes, no simple relationship between burden of disease and change in skin score was observed.

show abstract

“…The extent of skin involvement is currently the major criterion for classifying SSc patients as diffuse or limited and is included in the ACR/EU-LAR classification criteria (1). More importantly, it predicts visceral involvement and decreased survival (2,3).…”

Section: Introductionmentioning

confidence: 99%

Skin imaging in systemic sclerosis

Kang¹,

Abignano²,

Lettieri³

et al. 2014

Eur J Rheumatol

View full text Add to dashboard Cite

Fibrotic involvement of the skin is a cardinal feature of systemic sclerosis (SSc). The extent of skin involvement is associated with internal organ involvement, coinciding with more severe disease course and poor prognosis. A palpation-based semi-quantitative score, the modified Rodnan skin score, is widely used for the assessment of skin involvement, but it is entailed by significant limitations. More objective approaches to measure skin involvement employing imaging have been explored continuously in the past decades and are currently advancing. Here, we review the use of different imaging techniques for the assessment of skin involvement in patients with SSc, focusing mainly on ultrasound, magnetic resonance imaging, and optical coherence tomography.

show abstract

Improvement in skin thickening in systemic sclerosis associated with improved survival

Cited by 207 publications

References 15 publications

Recombinant human anti–transforming growth factor β1 antibody therapy in systemic sclerosis: A multicenter, randomized, placebo‐controlled phase I/II trial of CAT‐192

Recombinant human anti–transforming growth factor β1 antibody therapy in systemic sclerosis: A multicenter, randomized, placebo‐controlled phase I/II trial of CAT‐192

Relationship between change in skin score and disease outcome in diffuse cutaneous systemic sclerosis: Application of a latent linear trajectory model

Skin imaging in systemic sclerosis

Contact Info

Product

Resources

About