Date: Sunday, October 21, 2018
Session Title: Systemic Sclerosis and Related Disorders – Clinical Poster I
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Anti-U1RNP antibodies can be detected in patients with systemic sclerosis (SSc). However, their prevalence and clinical correlation with organ-specific complications have not been well characterized. The aim of the current study was to investigate the demographic and clinical features of SSc patients with anti-U1RNP antibodies using the European Scleroderma Trials and Research (EUSTAR) database.
SSc patients in the EUSTAR database with available data on anti-U1RNP antibodies were analyzed. Patients had to fulfill the 1980 American College of Rheumatology (ACR) or the 2013 ACR/European League Against Rheumatism (ACR/EULAR) classification criteria. Clinical characteristics were collected at the visit when the status of anti-U1RNP antibodies was first recorded.
Demographic and clinical parameters were compared between patients positive and negative for anti-U1RNP antibodies in univariate analysis followed by Bonferroni correction. Associations between anti-U1RNP status and involvement of multiple organs were tested in multivariate logistic regression models. Multiple imputation was used before regression analysis to handle missing values.
A total of 8391 patients were eligible for this analysis, among which 408 (4.9%) patients were positive for anti-U1RNP antibodies. Of the 8391 patients, the majority was female (84.9%), the median age was 57.0 years (IQR: 46.0-66.0). The median disease duration was 7.0 years (IQR: 3.0-13.0). Thirty-one percent patients had diffuse cutaneous involvement.
In univariate analysis, SSc patients positive for anti-U1RNP antibodies were significantly younger at disease onset (mean 37.9 vs 46.6 years), had higher prevalence of synovitis (19.3% vs 13.4%), pulmonary hypertension assessed by echocardiography (24.7% vs 15.9%), lung fibrosis diagnosed by chest X-ray or high-resolution computer tomography (53.1% vs 42.0%), proteinuria (12.6% vs 5.6%), erythrocyte sedimentation rate (ESR) >25mm/h (46.4% vs 31.4%) and hypocomplementemia (15.7% vs 7.1%) than those negative for anti-U1RNP antibodies.
By multivariate analysis, anti-U1RNP antibodies were confirmed to be independently associated with synovitis [odds ratio (OR) 1.47, 95% confidence interval (CI) 1.10 to 1.96], lung fibrosis (OR 1.36, 95% CI 1.06 to 1.76), pulmonary hypertension on echocardiography (OR 2.20, 95% CI 1.62 to 2.99), proteinuria (OR 2.27, 95% CI 1.56 to 3.31) and ESR>25mm/h (OR 2.11, 95% CI 1.65 to 2.71). In addition, there was a negative association with diffuse cutaneous involvement (OR 0.58, 95% CI 0.45 to 0.75).
This is the largest cohort of SSc patients positive for anti-U1RNP antibodies reported so far. It defines characteristic features associated with this specific subtype of SSc-patients. The detection of anti-u1RNP antibodies in SSc patients should be more emphasized and might be helpful for risk stratification during clinical practice.
To cite this abstract in AMA style:Wu W, Hoederath P, Hachulla E, Airò P, Valentini G, Matucci Cerinic M, Cozzi F, Riemekasten G, Allanore Y, Carreira P, Jordan S, Distler O. Demographic and Clinical Features of Systemic Sclerosis Patients with Anti-U1RNP Antibodies: A European Scleroderma Trials and Research (EUSTAR) Analysis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/demographic-and-clinical-features-of-systemic-sclerosis-patients-with-anti-u1rnp-antibodies-a-european-scleroderma-trials-and-research-eustar-analysis/. Accessed June 17, 2021.
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