Session Information
Date: Tuesday, November 15, 2016
Session Title: Systemic Sclerosis, Fibrosing Syndromes, and Raynaud's – Clinical Aspects and Therapeutics - Poster III
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: In a previous study it was demonstrated that, in patients with systemic sclerosis (SSc) the cumulative number of micro-haemorrhages (MH) and micro-thrombosis (MT) (the so called NEMO score), observed in nailfold videocapillaroscopy (NVC), was strongly predictive of disease activity (DA). [1].The present study is aimed at validating NEMO score as predictor of DA in different cohorts of patients.
Methods: The NEMO score, total number of giant capillaries (GC) and mean number of capillaries (Cs) were computed by eight finger NVC in 122 patients with SSc referring to the Rheumatic Disease Unit of the ‘Istituto G.Pini’ of Milan, where the preliminary study had been carried out (internal validation). The same procedure was performed in 97 patients collected in a different centre, i.e., the Rheumatic Dept. of the II University of Naples (external validation). In all of the patients DA was assessed at the same time of NVC performance by means of the European Scleroderma Study Group (ESSG) scoring system.
Results: Demographic and clinical characteristics of the patients were summarised in Table 1.
|
number of patients |
male/ female |
patients with lcSSc/dcSSc |
age (years) median (range) |
disease duration median (range) |
patients with a ESSG score≥3 |
|
| Milan Cohort |
122 |
8/114 |
60/62 |
52 (17-82) |
4 (0-28) |
57 |
| Naples Cohort |
97 |
9/88 |
72/25 |
55 (19-79) |
6 (0-36) |
30 |
| All patients |
219 |
17/202 |
132/87 |
53 (17-82) |
5 (0-36) |
87 |
lcSSc= limited cutaneous SSc; dcSSc=diffuse cutaneous SSc. Table 2: Main statistical results obtained by the analysis of the two cohorts.
|
correlation* between NEMO and ESSG score |
correlation* between GC and ESSG score |
NEMO ROC^ curve for ESSG score≥3 |
sens./spec. of NEMO>8 for ESSG score ≥3 |
|
| Milan Cohort |
R=0.69; p<0.0001 |
R=0.30; p<0.001 |
AUC°= 0.926 |
84.2/92.3 |
| Naples Cohort |
R=0.76; p<0.0001 |
R=0.39; p<0.0005 |
AUC°= 0.930 |
93.3/76.1 |
*by Spearman Rank correlation; ^ROC=receiver operating characteristic; °AUC=area under the curve; sens.=sensitivity; spec.= specificity. In a logistic regression model were NEMO, GC e Cs were considered the independent variables and a ESSG≥3 the dependent variable, only NEMO score showed to have a significant predictive value for DA.
Conclusion: This validation study confirms that the presence of a certain number of MH plus that of MT in eight finger NVC may represent a simple screening method to predict the presence of DA in patients with SSc. References. 1. Sambataro D, et al. Arthritis Res & Ther 2014;16:462.
To cite this abstract in AMA style:
Del Papa N, Andracco R, Irace R, Vettori S, Pignataro F, Maglione W, Zaccara E, Sambataro D, Valentini G, Vitali C. The Number of Micro-Haemorrhages and Micro-Thrombosis Detected By Nailfold Videocapillaroscopy Is a Good Predictor of Disease Activity in Systemic Sclerosis: The Validation Study of NEMO Score [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/the-number-of-micro-haemorrhages-and-micro-thrombosis-detected-by-nailfold-videocapillaroscopy-is-a-good-predictor-of-disease-activity-in-systemic-sclerosis-the-validation-study-of-nemo-score/. Accessed September 19, 2019.« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-number-of-micro-haemorrhages-and-micro-thrombosis-detected-by-nailfold-videocapillaroscopy-is-a-good-predictor-of-disease-activity-in-systemic-sclerosis-the-validation-study-of-nemo-score/