Calcinosis is associated with ischemic manifestations and increased disability in patients with systemic sclerosis

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dc.contributor.authorValenzuela, Antonia
dc.contributor.authorBaron, Murray
dc.contributor.authorRodriguez-Reyna, Tatiana S.
dc.contributor.authorProudman, Susanna
dc.contributor.authorKhanna, Dinesh
dc.contributor.authorYoung, Amber
dc.contributor.authorHinchcliff, Monique
dc.contributor.authorSteen, Virginia
dc.contributor.authorGordon, Jessica
dc.contributor.authorHsu, Vivien
dc.contributor.authorCastelino, Flavia, V
dc.contributor.authorSchoenfeld, Sara
dc.contributor.authorLi, Shufeng
dc.contributor.authorWu, Joy Y.
dc.contributor.authorFiorentino, David
dc.contributor.authorChung, Lorinda
dc.date.accessioned2025-01-23T19:47:32Z
dc.date.available2025-01-23T19:47:32Z
dc.date.issued2020
dc.description.abstractObjective: Calcinosis is a debilitating complication of systemic sclerosis (55c) with no effective treatments. We sought to identify clinical correlations and to characterize complications and disability associated with calcinosis in a multi-center, international cohort of 55c patients.
dc.description.abstractMethods: We established a cohort of 568 consecutive 55c patients who fulfill 2013 revised ACR/EULAR criteria at 10 centers within North America, Australia, and Mexico. Calcinosis was defined as subcutaneous calcium deposition by imaging and/or physical examination, or a clear history of extruded calcium. All patients completed the Scleroderma Health Assessment Questionnaire Disability Index and Cochin Hand Functional Scale.
dc.description.abstractResults: 215 (38%) patients had calcinosis. In multivariable analysis, disease duration (OR=1.24, p = 0.029), digital ischemia (OR=1.8, p = 0.002) and Acro-osteolysis (OR=2.97, p = 0.008) were significantly associated with calcinosis. In the subset of patients with bone densitometry (n = 68), patients with calcinosis had significantly lower median T-scores than patients without (-2.2 vs. -1.7, p = 0.004). The most common location of calcinosis lesions was the hands (70%), particularly the thumbs (19%) with decreasing frequency moving to the fifth fingers (8%). The most common complications were tenderness (29% of patients) and spontaneous extrusion of calcinosis through the skin (20%), while infection was rare (2%). Disability and hand function were worse in patients with calcinosis, particularly if locations in addition to the fingers thumbs were involved.
dc.description.abstractConclusions: We confirmed a strong association between calcinosis and digital ischemia. Calcinosis in SSc patients most commonly affects the hands and is associated with a high burden of disability and hand dysfunction. (C) 2020 Elsevier Inc. All rights reserved.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.semarthrit.2020.06.007
dc.identifier.eissn1532-866X
dc.identifier.issn0049-0172
dc.identifier.urihttps://doi.org/10.1016/j.semarthrit.2020.06.007
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/100390
dc.identifier.wosidWOS:000580602000016
dc.issue.numero5
dc.language.isoen
dc.pagina.final896
dc.pagina.inicio891
dc.revistaSeminars in arthritis and rheumatism
dc.rightsacceso restringido
dc.subjectScleroderma
dc.subjectCalcinosis
dc.subjectDigital ischemia
dc.subjectAcro-osteolysis
dc.subjectOsteoporosis
dc.subjectDisability
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCalcinosis is associated with ischemic manifestations and increased disability in patients with systemic sclerosis
dc.typeartículo
dc.volumen50
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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