Clinical trajectories of hand function impairment in systemic sclerosis: an unmet clinical need across disease subsets

BackgroundHand involvement is an early manifestation of systemic sclerosis (SSc), culprit of diagnosis and classification, and recognised major driver of disability. Impairment of hand function burdens both limited and diffuse cutaneous subsets and therefore could be targeted as ‘basket’ endpoint in...

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Published in:Rheumatic & musculoskeletal diseases open 2024-01, Vol.10 (1), p.e003216
Main Authors: De Lorenzis, Enrico, Kakkar, Vishal, Di Donato, Stefano, Wilson, Michelle, Barnes, Theresa, Denton, Chris, Derrett-Smith, Emma, Douglas, Karen, Helliwell, Philip, Herrick, Ariane L, Saleem, Benazir, Nisar, Muhammad, Morley, Catherine, Green, Lorraine, Alcacer-Pitarch, Begonya, Del Galdo, Francesco
Format: Article
Language:English
Subjects:
Clinical medicine
Hand
Humans
Male
Outcome Assessment, Health Care
Patient Reported Outcome Measures
Patients
Scleroderma
Scleroderma, Systemic - complications
Scleroderma, Systemic - diagnosis
Scleroderma, Systemic - epidemiology
Standard of care
Systemic Sclerosis
Ulcers
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Summary:BackgroundHand involvement is an early manifestation of systemic sclerosis (SSc), culprit of diagnosis and classification, and recognised major driver of disability. Impairment of hand function burdens both limited and diffuse cutaneous subsets and therefore could be targeted as ‘basket’ endpoint in SSc. Nevertheless, its natural history in current standard of care is not well characterised, limiting the design of targeted trials. The aim of this study is to describe prevalence, natural history and clinical factors associated with hand function deterioration in a longitudinal, multicentre, observational SSc cohort.MethodsHand function was captured through the validated Cochin Hand Function Scale in patients consecutively enrolled in a multicentre observational study and observed over 24 months. Minimal clinically important differences and patient acceptable symptom state were analysed as previously described.ResultsThree hundred and ninety-six consecutive patients were enrolled from 10 centres; 201 with complete follow-up data were included in the analysis. Median (IQR) disease duration was 5 (2–11) years. One hundred and five (52.2%) patients reported clinically significant worsening. Accordingly, the proportion of patients reporting unacceptable hand function increased over 2 years from 27.8% to 35.8% (p
ISSN:2056-5933
2056-5933
DOI:10.1136/rmdopen-2023-003216