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Title: | The association of low complement with disease activity in systemic sclerosis: A prospective cohort study. | Authors: | Esposito J.;Proudman S.M.;Walker J.;Roddy J.;Zochling J.;Rabusa C.;Sahhar J. ;Stevens W.;Brown Z.;Nikpour M. | Institution: | (Esposito, Nikpour) The University of Melbourne at St Vincent's Hospital (Melbourne), Department of Medicine, 41 Victoria Parade, Fitzroy, VIC 3065, Australia (Esposito, Brown, Stevens, Rabusa, Nikpour) St Vincent's Hospital (Melbourne), Department of Rheumatology, 41 Victoria Parade, Fitzroy, VIC 3065, Australia (Sahhar) Monash Health and Monash University, Department of Rheumatology, 246 Clayton Road, Clayton, VIC 3168, Australia (Sahhar) Monash Health and Monash University, Department of Medicine, 246 Clayton Road, Clayton, VIC 3168, Australia (Zochling) Menzies Institute for Medical Research, Department of Rheumatology, Private Bag 23, Hobart, TAS 7001, Australia (Roddy) Royal Perth Hospital, Department of Rheumatology, 197 Wellington Street, GPO Box X2213, Perth, WA 6001, Australia (Walker) Flinders Medical Centre, Department of Rheumatology, Flinders Drive, Bedford Park, SA 5042, Australia (Proudman) Royal Adelaide Hospital, Rheumatology Unit, North Terrace, Adelaide, SA 5000, Australia (Proudman) University of Adelaide, Discipline of Medicine, Adelaide, SA 5000, Australia | Issue Date: | 9-Nov-2016 | Copyright year: | 2016 | Publisher: | BioMed Central Ltd. (E-mail: info@biomedcentral.com) | Place of publication: | United Kingdom | Publication information: | Arthritis Research and Therapy. 18 (1) (no pagination), 2016. Article Number: 246. Date of Publication: 22 Oct 2016. | Journal: | Arthritis Research and Therapy | Abstract: | Background: In some rheumatic diseases such as systemic lupus erythematosus (SLE), low serum complement ('hypocomplementaemia') is a feature of active disease. However, the role of hypocomplementaemia in systemic sclerosis (SSc) is unknown. We sought to determine the frequency, clinical associations and relationship to disease activity of hypocomplementaemia in SSc. Method(s): The study included 1140 patients fulfilling the 2013 American College of Rheumatology criteria for SSc. Demographic, serological and clinical data, obtained prospectively through annual review, were analysed using univariable methods. Linear and logistic regression, together with generalised estimating equations, were used to determine the independent correlates of hypocomplementaemia ever, and at each visit, respectively. Result(s): At least one episode of hypocomplementaemia (low C3 and/or low C4) occurred in 24.1 % of patients over 1893 visits; these patients were more likely to be seropositive for anti-ribonucleoprotein (OR = 3.8, p = 0.002), anti-Ro (OR = 2.2, p = 0.002), anti-Smith (OR = 6.3, p = 0.035) and anti-phospholipid antibodies (OR = 1.4, p = 0.021) and were more likely to display features of overlap connective tissue disease, in particular polymyositis (OR = 16.0, p = 0.012). However, no association was found between hypocomplementaemia and either the European Scleroderma Study Group disease activity score or any of its component variables (including erythrocyte sedimentation rate) in univariate analysis. Among patients with SSc overlap disease features, those who were hypocomplementaemic were more likely to have digital ulcers (OR = 1.6, p = 0.034), tendon friction rubs (OR = 2.4, p = 0.037), forced vital capacity <80 % predicted (OR = 2.9, p = 0.008) and lower body mass index (BMI) (OR for BMI = 0.9, p < 0.0005) at that visit, all of which are features associated with SSc disease activity and/or severity. Conclusion(s): While hypocomplementaemia is not associated with disease activity in patients with non-overlap SSc, it is associated with some features of increased SSc disease activity in patients with overlap disease features.Copyright © 2016 The Author(s). | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1186/s13075-016-1147-2 | PubMed URL: | 27770830 [http://www.ncbi.nlm.nih.gov/pubmed/?term=27770830] | ISSN: | 1478-6354 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/39756 | Type: | Article | Subjects: | *complement component C3/ec [Endogenous Compound] CD20 antibody/dt [Drug Therapy] calcineurin inhibitor/dt [Drug Therapy] azathioprine/dt [Drug Therapy] systemic sclerosis/dt [Drug Therapy] *systemic sclerosis/dt [Drug Therapy] serology scoring system polymyositis practice guideline prediction adult antibody detection article body mass clinical feature cohort analysis *complement deficiency connective tissue disease controlled study demography *disease activity *disease association disease severity erythrocyte sedimentation rate female finger ulcer gastrointestinal reflux/dt [Drug Therapy] human major clinical study male abatacept/dt [Drug Therapy] cyclophosphamide/dt [Drug Therapy] hydroxychloroquine/dt [Drug Therapy] immunomodulating agent/dt [Drug Therapy] leflunomide/dt [Drug Therapy] methotrexate/dt [Drug Therapy] mycophenolic acid/dt [Drug Therapy] penicillamine/dt [Drug Therapy] phospholipid antibody/ec [Endogenous Compound] prednisolone/dt [Drug Therapy] prednisolone/po [Oral Drug Administration] proton pump inhibitor/dt [Drug Therapy] ribonucleoprotein antibody/ec [Endogenous Compound] Ro antibody/ec [Endogenous Compound] Sm antibody/ec [Endogenous Compound] tocilizumab/dt [Drug Therapy] tumor necrosis factor inhibitor/dt [Drug Therapy] European Scleroderma Study Group disease activity score prospective study multicenter study (topic) patient information *complement component C4/ec [Endogenous Compound] rheumatology *disease activity *disease association disease severity erythrocyte sedimentation rate clinical feature finger ulcer gastrointestinal reflux / drug therapy human major clinical study male multicenter study (topic) patient information polymyositis practice guideline prediction prospective study rheumatology scoring system serology *systemic sclerosis / *drug therapy systemic sclerosis / drug therapy body mass Article antibody detection adult female cohort analysis *complement deficiency connective tissue disease controlled study demography |
Type of Clinical Study or Trial: | Observational study (cohort, case-control, cross sectional or survey) |
Appears in Collections: | Articles |
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