Most Read Articles
Jairia Dela Cruz, 18 Dec 2018
The use of ixekizumab to selectively target interleukin-17A (IL-17A) in disease-modifying antirheumatic drug-naïve patients with ankylosing spondylitis yields improvements in disease activity, health-related quality of life, day-to-day physical activity, and bone marrow oedema of the spine and sacroiliac joint, according to the results of the phase III COAST-V study.
10 Jan 2019
Only a few sonographic enthesitis scoring instruments developed for spondyloarthritis (SpA) have been validated in psoriatic arthritis (PsA), and none of them passed the Outcome Measures in Rheumatology (OMERACT) filter in patients with PsA, according to a systematic review.

Severe gastrointestinal disease linked to increased mortality in early scleroderma

05 Jan 2019

Severe gastrointestinal (GI) involvement is common in early systemic sclerosis and is associated with an elevated risk of mortality and significant impairment in health-related quality of life, a study reports.

The study included 556 systemic sclerosis patients (311 Canadian and 245 Australian; mean age 54.0 years; 80.8 percent female) with <2 years of disease duration. Severe GI disease was defined as malabsorption, hyperalimentation, pseudo-obstruction and/or 10 percent weight loss in relation to the use of antibiotics for bacterial overgrowth or oesophageal stricture.

Researchers performed Kaplan–Meier, multivariate logistic regression and Cox proportional hazard analyses to determine the cumulative incidence rate, independent clinical correlates and mortality rate associated with severe GI disease.

In the population, 26 patients (4.7 percent) had severe GI disease at baseline while 46 (8.3 percent) developed it over a mean follow-up of 4.3 years. The probability of developing the disease was 9.1 percent at 2 years and 16.0 percent at 4 years. Risk factors included inflammatory myositis (odds ratio [OR], 4.68; 95 percent CI, 1.65–13.24), telangiectasias (OR, 2.45; 1.19–5.04) and modified Rodnan skin score (OR, 1.03; 1.01–1.07).

Severe GI disease was associated with a greater than twofold increase in the risk of death (hazard ratio, 2.27; 1.27–4.09) and worse health-related quality of life (Short Form Health Survey physical and mental component summary scores, p=0.02 and p=0.01, respectively).

The findings indicate that myositis is the strongest independent predictor of severe GI disease and suggest that a common pathway might be targeted to address both the skeletal muscle and intestinal smooth muscle involvement, researchers said. More studies should be conducted to further the understanding of this serious manifestation of systemic sclerosis, as well as to identify preventive strategies.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Rheumatology digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Jairia Dela Cruz, 18 Dec 2018
The use of ixekizumab to selectively target interleukin-17A (IL-17A) in disease-modifying antirheumatic drug-naïve patients with ankylosing spondylitis yields improvements in disease activity, health-related quality of life, day-to-day physical activity, and bone marrow oedema of the spine and sacroiliac joint, according to the results of the phase III COAST-V study.
10 Jan 2019
Only a few sonographic enthesitis scoring instruments developed for spondyloarthritis (SpA) have been validated in psoriatic arthritis (PsA), and none of them passed the Outcome Measures in Rheumatology (OMERACT) filter in patients with PsA, according to a systematic review.