title: Sequential nailfold videocapillaroscopy examinations have responsiveness to detect organ progression in systemic sclerosis.
abstract: To determine the merit of nailfold videocapillaroscopy (NVC) to detect meaningful microvascular changes over time in patients with systemic sclerosis (SSc) and whether these changes are associated with overall disease progression and organ involvements.
  
  
  
  A prospective cohort of 140 SSc patients was recruited over a 12-month period and was followed up on an annual basis for 3 years. Detailed NVC analysis was performed at inclusion and repeated annually. Disease progression and organ damage were defined according to validated definitions.
  
  
  
  Significant NVC changes were detected in 72 SSc patients (51%) during the follow-up period. Patients with incident or increased number of giant capillaries were less at risk to develop new digital ulcers (DU) [hazard ratio (HR) = 0.53, 95% confidence interval (CI): 0.07-0.93]. Loss of capillaries over time was confirmed as a robust and independent marker of organ progression. The reduction of the number of capillaries was associated with overall disease progression (HR = 4.35, 95% CI: 1.87-10.12), occurrence of new DU (HR = 5.33, 95% CI: 1.69-16.71), lung vascular progression (HR = 18.53, 95% CI: 1.28-78.33), progression of skin fibrosis (HR = 4.22, 95% CI: 1.24-14.36), and worsening of the Medsger severity score (HR = 5.26, 95% CI: 1.78-15.52).
  
  
  
  Significant NVC changes are observed in almost half of the patients with SSc during a follow-up of 3 years. Sequential NVC examinations have responsiveness to detect disease progression. Sequential NVC is confirmed of value to monitor SSc, as well as progressive loss of capillaries over time as a potential surrogate marker for disease progression.
authors.affiliation: Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France. Electronic address: jerome.avouac@cch.aphp.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Avouac
authors.affiliation: Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France; Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy.
authors.forename: Gemma
authors.initials: G
authors.lastname: Lepri
authors.affiliation: Department of Rheumatology, Faculty of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Smith
authors.affiliation: Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
authors.forename: Elide
authors.initials: E
authors.lastname: Toniolo
authors.affiliation: Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hurabielle
authors.affiliation: Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Vallet
authors.affiliation: Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
authors.forename: Fazia
authors.initials: F
authors.lastname: Amrouche
authors.affiliation: Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
authors.forename: André
authors.initials: A
authors.lastname: Kahan
authors.affiliation: Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cutolo
authors.affiliation: Rheumatology A department, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cité, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy / Q000379:methods*; D018715:Microscopy, Video; D008875:Middle Aged; D009262:Nails / Q000098:blood supply / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology; D012720:Severity of Illness Index
keywords: Digital ulcers; Disease progression; Nailfold videocapillaroscopy; Systemic sclerosis