Osteoarticular manifestations of systemic sclerosis: a systematic review of the literature

Molina-Ríos, Sebastián; Eliana, Ordoñez C.; Quintana-López, Gerardo

doi:10.1016/j.rcreue.2020.01.001

Cited by 2 publications

(1 citation statement)

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“…Another important result of our study is the finding that physical disability, a partially modifiable risk factor (26)(27)(28)(29), is associated with a high fracture rate in patients with SSc. Musculoskeletal involvement such as joint contracture, myopathy, and arthritis are common features of SSc (30), which can lead to disability and impaired quality of life (1,23,31,32). Various local and global therapeutic rehabilitation programs (i.e., home exercises [29], manual lymphatic drainage [28], paraffin wax baths [33], connective tissue massage [34], joint manipulation [34], physical and occupational therapy [35,36], and aerobic exercises [37]) were noted to improve the function of patients with SSc.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features Associated With Rate of Fractures in Patients With Systemic Sclerosis: A US Cohort Study

Rogers

Famenini

Perin

et al. 2023

Arthritis Care & Research

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ObjectiveSystemic sclerosis (SSc) is associated with several specific risk factors for fracture due to the complications of the disease and related medications. The present study was undertaken to examine the relationship between SSc‐associated clinical features and fracture rate in a large US cohort.MethodsParticipants with SSc in FORWARD, The National Databank for Rheumatic Diseases, were included (1998–2019). Age‐ and sex‐matched individuals with osteoarthritis (OA) from the same database were included as comparators. The primary end point was self‐reported major osteoporotic fracture. Cox proportional hazards models were used to study the associations between risk factors and fractures.ResultsThe study included 922 individuals (SSc patients, n = 154; OA patients, n = 768). Eighty‐seven percent were female, with a mean age of 57.8 years. Fifty‐one patients developed at least 1 fracture during a median of 4.2 years (0.5–22.0 years) of follow‐up. Patients with SSc had more frequent fractures compared to OA comparators (hazard ratio [HR] 2.38 [95% confidence interval (95% CI) 1.47–3.83]). Among patients with SSc, a higher Rheumatic Disease Comorbidity Index score (HR 1.45 [95% CI 1.20–1.75]) and a higher Health Assessment Questionnaire disability index score (HR 3.83 [95% CI 2.12–6.93]) were associated with more fractures. Diabetes mellitus (HR 5.89 [95% CI 2.51–13.82]) and renal disease (HR 2.43 [95% CI 1.10–5.37]) were independently associated with fracture among SSc patients relative to SSc patients without these comorbidities.ConclusionOur findings highlight factors associated with fracture among patients with SSc. Disability as measured by the HAQ DI is a particularly strong indicator of fracture rate in SSc. Improving SSc patients’ functional status, where possible, may lead to better long‐term outcomes.

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