Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: The European Scleroderma Study Group (EScSG) Activity Index developed in 2001 has some limitations due to the procedure underlying its development and the inclusion of hypocomplementemia, that was criticized for its poor face validity. The present study is devoted to overcome such limitations.
Methods: Ninety seven clinical charts of patients with SSc, all of whom satisfying 1980 ACR criteria for the disease, were retrieved from a large database. Three investigators (CD, OKB, YA) external to the enrolling centres assigned a disease activity score to each chart on a 0-10 visual analogue scale, providing a reliable scoring tool (ICC=0.786; 95%CI=0.716-0.844). The median score served as the disease activity gold standard. Another investigator (GV) evaluated disease activity as inactive, moderately active, active, and very active. Univariate and multivariate linear regression analyses were used to assess the performance of sets of criteria in predicting the “gold standard” and to identify the weight of each variable. Pending the final validation in a replication cohort, the resulting preliminary activity index was validated by the jackknife statistical procedure i.e.by leaving out one patient a time. Receiver operating curves served to assess the efficiency of the index in separating active-very active disease from inactive-moderately active disease.
Results: A preliminary weighted 10-point activity index was identified: Δ (ie. patient-assessed worsening during the previous month)-skin= 1.25, Δ- heart-lung= 0.75, modified Rodnan skin score >18=1.25; digital ulcers=1.75; tendon friction rubs=1.5; erythrocyte sedimentation rate >50 mm/h=1.0; C reactive protein >1 mg/dl= 1.5; Diffusing Lung Capacity for CO <70% of predicted=1. A cut-off ≥1.75 identified patients with active-very active disease. It resulted to be more sensitive and specific than the currently used EScSG index in identifying SSc patients with active disease in the 97 SSc patients considered for this part of the study.
Conclusion: A preliminary revised activity index has been developed. It is feasible and has face validity. It is going to be validated in a replication cohort
To cite this abstract in AMA style:Valentini G, Iudici M, Jaeger VK, Denton CP, Distler O, Kowal-Bielecka OM, Müller-Ladner U, Riemekasten G, Walker UA, Jordan S, Siegert E, Vettori S, Allanore Y. Identification of a New Set of Activity Criteria for Systemic Sclerosis. Preliminary Report [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/identification-of-a-new-set-of-activity-criteria-for-systemic-sclerosis-preliminary-report/. Accessed March 23, 2019.
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