ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 674

Systemic Sclerosis Disease Subset Is a Better Predictor Of Long Term Outcome Than Autoantibody Profile

Svetlana I. Nihtyanova1, Voon H. Ong2 and Christopher P. Denton3, 1Department of Rheumatology, Royal Free and University College Medical School, London, United Kingdom, 2Department of Rheumatology, The Royal Free and University College Medical School, London, United Kingdom, 3Centre for Rheumatology, Royal Free and University College Medical School, London, United Kingdom

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Antibodies, morbidity and mortality, scleroderma and systemic sclerosis

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Title: Systemic Sclerosis, Fibrosing Syndromes, and Raynaud’s - Clinical Aspects and Therapeutics I

Session Type: Abstract Submissions (ACR)

Background/Purpose: Disease subset has been shown to strongly correlate with survival and risk of organ complications in patients with systemic sclerosis (SSc). Nevertheless evidence in the literature suggests that SSc-specific autoantibodies may be a better predictor of SSc-associated morbidity and mortality.

Methods: We explore subset and autoantibodies as predictors of outcome in a large, well-characterised cohort of consecutive unselected SSc patients.

Results: We analysed 649 contemporary SSc patients, 59% with limited cutaneous (lc)SSc and 41% with diffuse cutaneous (dc)SSc. Of those, 25% carried anti-centromere antibody (ACA), 23% anti-topoisomerase-I antibody (ATA), 10.5% anti-RNA polymerase antibody (ARA), 4.6% anti-U3RNP,6% anti-U1-RNP, 4% anti-Pm-Scl, 18% were ANA positive, but without a defined ENA reactivity, 3.4% were ANA negative and 6% had other rarer antibodies, including Th/To, Ku, Jo1, Ro, La, SL, PL7, PL12, SL and XR.

As previously described, the strongest association with subset was observed in ACA+ patients, of whom 98% had lcSSc, while ARA+ subjects had predominantly dcSSc (91%). Although more frequent in dcSSc patients, 44% of ATA and 40% of anti-U3RNP subjects had lcSSc.

Cox regression analysis confirmed that ATA has the strongest positive association with pulmonary fibrosis (PF) – HR 3.8 (95%CI 2.9-5.1, p<0.001) and ACA has the strongest protective effect – HR 0.1 (95%CI 0.05-0.2, p<0.001). In this cohort there was also a significant negative association between PF and ARA (HR 0.5, 95%CI 0.3-0.9, p=0.018) and anti-U3RNP (HR 0.2, 95%CI 0.05-0.8, p=0.023). Although dcSSc is associated with significantly increased risk of PF, the effect of the antibodies was independent of subset.

Anti-U3RNP was associated with an increase (HR 2.9, 95%CI 1.4-5.8, p=0.003) while ATA with a reduction (HR 0.4, 95%CI 0.2-0.8, p=0.01) of the overall hazard for PH. Incidence of PH did not differ in the two subsets and correction for subset did not alter the predictive value of the antibodies.

We also confirmed the strong association between scleroderma renal crisis (SRC) and ARA (HR 7.5, 95%CI 4.2-13.2, p<0.001) and the protective role of ACA in SRC patients (HR 0.06, 95%CI 0.01-0.4, p=0.005), which were observed both within the subsets and for the cohort as a whole. There was also a negative association between SRC and ATA (HR 0.4, 95%CI 0.15-0.9, p=0.037) in the whole group, but in the subset analysis the effect held only for dcSSc patients. We found no associations between cardiac SSc and any of the antibodies.

The only antibody specificity that demonstrated significant association with survival in the whole cohort was ACA (HR 0.7, 95%CI 0.5-0.9, p=0.022), although in the analysis within subsets the association was no longer significant, suggesting that the better survival among ACA+ patients is due to the predominantly limited skin involvement in this group.

Conclusion: While ANA reactivities are strong predictors of organ complications, generally independent of disease subset, they correlate poorly with survival. Disease subset is a much better predictor of mortality and this may reflect severity rather than presence of individual organ-based complications.


Disclosure:

S. I. Nihtyanova,
None;

V. H. Ong,
None;

C. P. Denton,
None.

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/systemic-sclerosis-disease-subset-is-a-better-predictor-of-long-term-outcome-than-autoantibody-profile/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology