The value of pattern capillary changes and antibodies to predict the development of systemic sclerosis in patients with primary Raynaud's phenomenon.
The aim of this study is to assess the prognostic value of major provisional criteria for the development of systemic sclerosis (SSc) in primary Raynaud's phenomenon (RP) patients. We retrospectively studied the chart of 497 patients with primary RP in whom anticentromere (ACA) and antitopoisomerase I (ATA) antibodies tests and a capillary reading were available. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratios (LHR+), negative likelihood ratios (LHR-), odds ratio (OR), and area under the receiver operating characteristics curve (AUC) of those criteria were assessed to predict the development of SSc. During the average follow-up of 2.3 ± 1.9 years, 159 (32 %) patients evolved to SSc, 245 (49.3 %) evolved to other connective tissue diseases, and 93 (18.7 %) patients did not progress. The SSc pattern predicted SSc satisfactorily (LHR+ 4.12, LHR- 0.07, OR 63, AUC 0.819; P < 0.001). ACA were not significantly associated with the development of SSc (LHR+ 1.19, LHR- 0.9, OR 1.32, AUC 0.538, P = 0.156). ATA were significantly associated with the development of SSc (LHR+ 9.32, LHR- 0.67, OR 15.13, AUC 0.777; P < 0.001). Both SSc pattern and ACA or ATA were significantly associated with the development of SSc (LHR+ 2.98, LHR- 0.70, OR 4.2, AUC 0.674; P < 0.001 vs. LHR+ 16, LHR- 0.68, OR 24, AUC 0.819; P < 0.001, respectively). SSc pattern or ATA as independent risk factors, as well as following two parameters together (SSc pattern and ATA or SSc pattern and ACA) were good predictors for the development of SSc.
Institute of Rheumatology Belgrade, Resavska 69, 11000, Belgrade, Serbia, dolijan@eunet.rs.
Slavica R
SR
Pavlov-Dolijanovic
Nemanja S
NS
Damjanov
Nada Z
NZ
Vujasinovic Stupar
Snezana
S
Baltic
Dragan D
DD
Babic
D000328:Adult; D000906:Antibodies / Q000097:blood*; D000974:Antibodies, Antinuclear / Q000097:blood*; D002196:Capillaries / Q000473:pathology*; D004264:DNA Topoisomerases, Type I / Q000276:immunology*; D006801:Humans; D020678:Microscopic Angioscopy; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011928:Raynaud Disease / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000209:etiology* / Q000276:immunology; D012680:Sensitivity and Specificity
D000906:Antibodies; D000974:Antibodies, Antinuclear; C538950:anticentromere antibody; D004264:DNA Topoisomerases, Type I