Session Information
Date: Monday, November 9, 2015
Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Clinical Aspects and Therapeutics Poster II
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Calcinosis is the deposition of calcium hydroxyapatite in the soft tissues in patients with scleroderma spectrum disorders (SSc). Risk factors are unknown and there is no effective medical treatment.
Methods: In this IRB-approved study, we compared clinical characteristics of SSc (1) patients with (SSc-calcinosis) and without calcinosis (SSc-control) seen consecutively in the outpatient Rutgers-RWJ Scleroderma Program. Our analysis included demographic and SSc clinical characteristics, comorbidities (osteoporosis, hypertension, diabetes and thyroid disease), autoantibodies (ANA, Scleroderma and Anti-Centromere) and imaging results. Univariate and multivariate regression analyses were conducted to determine common factors associated with calcinosis.
Results: There were 215 SSc patients enrolled, 65 SSc-calcinosis (81.5% were females) and 150 SSc-controls (77% were females). SSc-calcinosis patients were older (p=0.026) with significantly longer disease duration (20 ± 10.5 years vs 12 ± 8 years, p<0.0001). Twenty nine (45%) SSc-calcinosis patients had diffuse scleroderma and 15 (23%) also had overlap with other rheumatic diseases (2, 3). In the univariate analysis (see Table 1), Caucasian females with limited SSc, advanced age, longer disease duration, presence of osteoporosis and the Anti-centromere antibody were all statistically significant. In the multivariate analysis, SSc-calcinosis patients had significantly less ischemic digital ulcer history, but , longer disease duration and osteoporosis (adjusted for age) remained independently associated with calcinosis.
Conclusion: Calcinosis is common in both limited and diffuse SSc. Those with longer disease duration and osteoporosis may be at higher risk to develop calcinosis. Larger studies are needed to confirm these observations.
References:
- Hoogen FVD et al. Ann Rheum Dis, 2013; 72:1747-1755 and Arthritis Rheum, 2013; 65(11):2737-57.
- Aletaha D et al. Arthritis Rheum, 2010; 62:2569–2581.
- Mastagia FL et al. Rheum Dis.Clin. North Am, 2002; 28(4): 723-41.
Table 1: Analyses of clinical characteristics associated with and without SSc-calcinosis
|
|
Univariate Analysis |
Multivariate Analysis |
|||||
|
|
p-value |
OR |
95% CI |
p-value |
OR |
95% CI |
|
|
Age (years) |
0.0257 |
|
|
0.0693 |
|
|
|
|
Sex |
0.01 |
3.44 |
1.27 – 9.25 |
0.8490 |
0.8346 |
0.12 – 5.36 |
|
|
Disease onset (from Raynaud onset) |
<0.0001 |
|
|
0.0024 |
|
|
|
|
Disease onset (from non-Raynaud symptoms) |
<0.0001 |
|
|
0.0274 |
|
|
|
|
Race (Caucasian vs. other) |
0.0164 |
|
|
0.1625 |
0.098 – 1.47 |
||
|
Diagnosis of limited SSc |
0.0292 |
0.514 |
0.281 – 0.93 |
0.1553 |
2.895 |
0.668 – 12.53 |
|
|
Myopathy |
0.030 |
0.34 |
0.127 – 0.93 |
0.7066 |
0.6961 |
0.105 – 4.59 |
|
|
Pulmonary fibrosis |
0.0499 |
0.54 |
0.299 – 1.00 |
|
|
|
|
|
Ischemic digital ulcer history |
<0.0001 |
0.1906 |
0.092 – 0.39 |
0.0001 |
0.0522 |
0.012 – 0.22 |
|
|
Acro-osteolysis |
0.0565 |
2.124 |
0.970 – 4.64 |
|
|
|
|
|
Osteoporosis |
0.0001 |
3.2387 |
1.760 – 5.95 |
0.0122 |
5.2018 |
1.432 – 18.88 |
|
|
Anti-nuclear Antibody (ANA) |
0.0263 |
0.4013 |
0.176 – 0.91 |
0.0740 |
0.2108 |
0.038 – 1.162 |
|
|
Scleroderma Antibody (Scl70) |
0.3424 |
0.72 |
0.365 – 1.42 |
|
|
|
|
|
Anti-centromere Antibody |
0.0469 |
2.020 |
1.002 – 4.06 |
0.8406 |
1.199 |
0.203 – 7.083 |
|
To cite this abstract in AMA style:
Pai S, Hsu V. Are There Risk Factors for Calcinosis in Scleroderma? [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/are-there-risk-factors-for-calcinosis-in-scleroderma/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/are-there-risk-factors-for-calcinosis-in-scleroderma/