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- Title
Gastrointestinal symptom severity and progression in systemic sclerosis.
- Authors
Leeuwen, Nina M van; Boonstra, Maaike; Fretheim, Håvard; Brunborg, Cathrine; Midtvedt, Øyvind; Garen, Torhild; Molberg, Øyvind; Huizinga, Tom W J; Vries-Bouwstra, Jeska K de; Hoffman-Vold, Anna-Maria
- Abstract
Objectives To evaluate the severity and evolution of patient-reported gastrointestinal tract (GIT) symptoms in systemic sclerosis (SSc) patients, assess predictive factors for progression and determine the impact of standard of care treatment. Methods SSc patients from the Leiden and Oslo cohorts were included. We assessed clinical data and patient-reported GIT symptoms measured by the validated University of California, Los-Angeles Gastrointestinal-tract (UCLA-GIT) score at baseline and annually. GIT severity and progression was determined. Logistic regression was applied to identify risk factors associated with baseline GIT symptom severity. Linear mixed-effect models were applied to assess progression in GIT symptom burden and to identify predictive factors. We repeated all analysis in patients with early disease (inception cohort) to exclude the effect of longstanding disease and increase insights in development of GIT symptom burden early in the disease course. Results We included 834 SSc patients with baseline UCLA GIT scores, 454 from Leiden and 380 from Oslo. In the total cohort, 28% reported moderate-severe GIT symptoms at baseline, with increased risk for severity conferred by ACA, smoking and corticosteroid use, while use of calcium channel blockers appeared protective. In the inception cohort, 23% reported moderate-severe GIT symptoms at baseline, with increased risk for females and with smoking. Over time, symptom burden increased mainly for reflux/bloating. Female sex and ACA predicted GIT symptom progression. Conclusion High GIT symptom burden is present early in SSc disease course. Both for prevalence and for progression of GIT symptom burden, female sex and smoking were identified as risk factors.
- Subjects
DISEASE progression; AUTOANTIBODIES; ADRENOCORTICAL hormones; HEALTH outcome assessment; GASTROINTESTINAL diseases; SYSTEMIC scleroderma; SEVERITY of illness index; TREATMENT effectiveness; RISK assessment; GASTROESOPHAGEAL reflux; LOGISTIC regression analysis; SMOKING; ABDOMINAL bloating; EVALUATION
- Publication
Rheumatology, 2022, Vol 61, Issue 10, p4024
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/keac118