دورية أكاديمية
Treatment outcome in early diffuse cutaneous systemic sclerosis: the European Scleroderma Observational Study (ESOS)
| العنوان: | Treatment outcome in early diffuse cutaneous systemic sclerosis: the European Scleroderma Observational Study (ESOS) |
|---|---|
| المؤلفون: | Herrick, AL, Pan, X, Peytrignet, S, Lunt, M, Hesselstrand, R, Mouthon, L, Silman, A, Brown, E, Czirják, L, Distler, JHW, Distler, O, Fligelstone, K, Gregory, WJ, Ochiel, R, Vonk, M, Ancuţa, C, Ong, VH, Farge, D, Hudson, M, Matucci-Cerinic, M, Balbir-Gurman, A, Midtvedt, Ø, Jordan, AC, Jobanputra, P, Stevens, W, Moinzadeh, P, Hall, FC, Agard, C, Anderson, ME, Diot, E, Madhok, R, Akil, M, Buch, MH, Chung, L, Damjanov, N, Gunawardena, H, Lanyon, P, Ahmad, Y, Chakravarty, K, Jacobsen, S, MacGregor, AJ, McHugh, N, Müller-Ladner, U, Riemekasten, G, Becker, M, Roddy, J, Carreira, PE, Fauchais, AL, Hachulla, E, Hamilton, J, İnanç, M, McLaren, JS, van Laar, JM, Pathare, S, Proudman, S, Rudin, A, Sahhar, J, Coppere, B, Serratrice, C, Sheeran, T, Veale, DJ, Grange, C, Trad, G-S, Denton, CP |
| سنة النشر: | 2017 |
| المجموعة: | The University of Liverpool Repository |
| الوصف: | Objectives: The rarity of early diffuse cutaneoussystemic sclerosis (dcSSc) makes randomised controlledtrials very difficult. We aimed to use an observationalapproach to compare effectiveness of currently usedtreatment approaches. Methods: This was a prospective, observational cohortstudy of early dcSSc (within three years of onset of skinthickening). Clinicians selected one of four protocols foreach patient: methotrexate, mycophenolate mofetil(MMF), cyclophosphamide or‘no immunosuppressant’.Patients were assessed three-monthly for up to24 months. The primary outcome was the change inmodified Rodnan skin score (mRSS). Confounding byindication at baseline was accounted for using inverseprobability of treatment (IPT) weights. As a secondaryoutcome, an IPT-weighted Cox model was used to testfor differences in survival. Results: Of 326 patients recruited from 50 centres,65 were prescribed methotrexate, 118 MMF, 87cyclophosphamide and 56 no immunosuppressant.276 (84.7%) patients completed 12 and 234 (71.7%)24 months follow-up (or reached last visit date). Therewere statistically significant reductions in mRSS at12 months in all groups:−4.0 (−5.2 to−2.7) units formethotrexate,−4.1 (−5.3 to−2.9) for MMF,−3.3(−4.9 to−1.7) for cyclophosphamide and−2.2 (−4.0to−0.3) for no immunosuppressant (p value forbetween-group differences=0.346). There were nostatistically significant differences in survival betweenprotocols before (p=0.389) or after weighting(p=0.440), but survival was poorest in the noimmunosuppressant group (84.0%) at 24 months. Conclusions: Thesefindings may support usingimmunosuppressants for early dcSSc but suggest thatoverall benefit is modest over 12 months and that bettertreatments are needed. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| العلاقة: | http://livrepository.liverpool.ac.uk/3007777/1/ESOS_for%20Annals%204-9-16.docxTest; http://livrepository.liverpool.ac.uk/3007777/3/ESOS_Tables4-9-16a.docxTest; http://livrepository.liverpool.ac.uk/3007777/5/ESOSfigures4-9-16.docxTest; Collapse authors list. Herrick, AL, Pan, X, Peytrignet, S, Lunt, M, Hesselstrand, R, Mouthon, L, Silman, A, Brown, E, Czirják, L, Distler, JHW et al (show 54 more authors) , Distler, O, Fligelstone, K, Gregory, WJ, Ochiel, R, Vonk, M, Ancuţa, C, Ong, VH, Farge, D, Hudson, M, Matucci-Cerinic, M, Balbir-Gurman, A, Midtvedt, Ø, Jordan, AC, Jobanputra, P, Stevens, W, Moinzadeh, P, Hall, FC, Agard, C, Anderson, ME, Diot, E, Madhok, R, Akil, M, Buch, MH, Chung, L, Damjanov, N, Gunawardena, H, Lanyon, P, Ahmad, Y, Chakravarty, K, Jacobsen, S, MacGregor, AJ, McHugh, N, Müller-Ladner, U, Riemekasten, G, Becker, M, Roddy, J, Carreira, PE, Fauchais, AL, Hachulla, E, Hamilton, J, İnanç, M, McLaren, JS, van Laar, JM, Pathare, S, Proudman, S, Rudin, A, Sahhar, J, Coppere, B, Serratrice, C, Sheeran, T, Veale, DJ, Grange, C, Trad, G-S and Denton, CP (2017) Treatment outcome in early diffuse cutaneous systemic sclerosis: the European Scleroderma Observational Study (ESOS). Annals of the rheumatic diseases, 76 (07). 1207 - 1218. |
| الإتاحة: | http://livrepository.liverpool.ac.uk/3007777Test/ http://livrepository.liverpool.ac.uk/3007777/1/ESOS_for%20Annals%204-9-16.docxTest http://livrepository.liverpool.ac.uk/3007777/3/ESOS_Tables4-9-16a.docxTest http://livrepository.liverpool.ac.uk/3007777/5/ESOSfigures4-9-16.docxTest |
| رقم الانضمام: | edsbas.14059D23 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |