Treatment with mycophenolate mofetil is associated with improved nailfold vasculature in systemic sclerosis
(2023) In Rheumatology (Oxford, England)- Abstract
OBJECTIVE: To investigate the evolution of nailfold capillary density in patients with systemic sclerosis (SSc) in relation to immunosupressive treatment and autoantibodies.
METHODS: Prospective study cohort. Consecutive newly diagnosed SSc patients were included into this study who, in a retrospective review, had at least 2 nailfold capillary microscopy (NCM) measurements performed during the first 48 months of follow-up. Capillary density per 3 mm was measured with widefield NCM. Improvement of capillary density per finger and mean capillary density were analysed. Longitudinal measurements of mean capillary density were analysed by generalized estimating equation (GEE).
RESULTS: Eighty patients (68 women, 12 men) met the... (More)
OBJECTIVE: To investigate the evolution of nailfold capillary density in patients with systemic sclerosis (SSc) in relation to immunosupressive treatment and autoantibodies.
METHODS: Prospective study cohort. Consecutive newly diagnosed SSc patients were included into this study who, in a retrospective review, had at least 2 nailfold capillary microscopy (NCM) measurements performed during the first 48 months of follow-up. Capillary density per 3 mm was measured with widefield NCM. Improvement of capillary density per finger and mean capillary density were analysed. Longitudinal measurements of mean capillary density were analysed by generalized estimating equation (GEE).
RESULTS: Eighty patients (68 women, 12 men) met the inclusion criteria. The median follow-up time was 27 months. Twenty-eight patients had an improved capillary density in per finger analysis. Mycophenolate mofetil (MMF) was associated with less numbers of fingers that had worsened in capillary density. Anti-topoisomerase antibodies were associated with low mean capillary density. Anti-RNA polymerase III antibodies were associated with improvement and anti-centromere antibodies with worsening of capillary density in per finger analysis. MMF treatment was associated with less steep capillary density decline in a moderated GEE model including presence of anti-topoisomerase antibodies and the interaction of MMF with follow-up time.
CONCLUSION: Nailfold capillary density improved over time in a substantial proportion of SSc patients. MMF treatment had a positive impact on the evolution of capillary density in these patients. SSc autoantibody phenotype may affect the capillary density development. The data support previous hypotheses that early immunosuppression may favourably affect vascular regeneration in SSc.
(Less)
- author
- Wildt, Marie LU ; Andréasson, Kristofer LU ; Hamberg, Viggo ; Hesselstrand, Roger LU and Wuttge, Dirk M LU
- organization
- publishing date
- 2023-05-09
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Rheumatology (Oxford, England)
- article number
- kead207,
- publisher
- Oxford University Press
- external identifiers
-
- pmid:37158586
- scopus:85184505732
- ISSN
- 1462-0332
- DOI
- 10.1093/rheumatology/kead207
- language
- English
- LU publication?
- yes
- id
- 9ec697be-a8da-47e6-9d71-9da1227f6d6f
- date added to LUP
- 2023-05-11 09:54:37
- date last changed
- 2024-05-04 08:35:11
@article{9ec697be-a8da-47e6-9d71-9da1227f6d6f,
abstract = {{<p>OBJECTIVE: To investigate the evolution of nailfold capillary density in patients with systemic sclerosis (SSc) in relation to immunosupressive treatment and autoantibodies.</p><p>METHODS: Prospective study cohort. Consecutive newly diagnosed SSc patients were included into this study who, in a retrospective review, had at least 2 nailfold capillary microscopy (NCM) measurements performed during the first 48 months of follow-up. Capillary density per 3 mm was measured with widefield NCM. Improvement of capillary density per finger and mean capillary density were analysed. Longitudinal measurements of mean capillary density were analysed by generalized estimating equation (GEE).</p><p>RESULTS: Eighty patients (68 women, 12 men) met the inclusion criteria. The median follow-up time was 27 months. Twenty-eight patients had an improved capillary density in per finger analysis. Mycophenolate mofetil (MMF) was associated with less numbers of fingers that had worsened in capillary density. Anti-topoisomerase antibodies were associated with low mean capillary density. Anti-RNA polymerase III antibodies were associated with improvement and anti-centromere antibodies with worsening of capillary density in per finger analysis. MMF treatment was associated with less steep capillary density decline in a moderated GEE model including presence of anti-topoisomerase antibodies and the interaction of MMF with follow-up time.</p><p>CONCLUSION: Nailfold capillary density improved over time in a substantial proportion of SSc patients. MMF treatment had a positive impact on the evolution of capillary density in these patients. SSc autoantibody phenotype may affect the capillary density development. The data support previous hypotheses that early immunosuppression may favourably affect vascular regeneration in SSc.</p>}},
author = {{Wildt, Marie and Andréasson, Kristofer and Hamberg, Viggo and Hesselstrand, Roger and Wuttge, Dirk M}},
issn = {{1462-0332}},
language = {{eng}},
month = {{05}},
publisher = {{Oxford University Press}},
series = {{Rheumatology (Oxford, England)}},
title = {{Treatment with mycophenolate mofetil is associated with improved nailfold vasculature in systemic sclerosis}},
url = {{http://dx.doi.org/10.1093/rheumatology/kead207}},
doi = {{10.1093/rheumatology/kead207}},
year = {{2023}},
}