Prediction of damage trajectories in systemic sclerosis using group-based trajectory modelling

Lara D. Veeken, vol. 62, pp. 3059–3066

Abstract

OBJECTIVES: Damage accrual in SSc can be tracked using the Scleroderma Clinical Trials Consortium Damage Index (DI). Our goal was to develop a prediction model for damage accrual in SSc patients with early disease. METHODS: Using patients with <2 years disease duration from Canada and Australia as a derivation cohort, and from the Netherlands as a validation cohort, we used group-based trajectory modelling (GBTM) to determine 'good' and 'bad' latent damage trajectories. We developed a prediction model from this analysis and applied it to patients from derivation and validation cohorts. We plotted the actual DI trajectories of the patients predicted to be in 'good' or 'bad' groups. RESULTS: We found that the actual trajectories of damage accumulation for lcSSc and dcSSc were very different, so we studied each subset separately. GBTM found two distinct trajectories in lcSSc and three in dcSSc. We collapsed the two worse trajectories in the dcSSc into one group and developed a prediction model for inclusion in either 'good' or 'bad' trajectories. The performance of models using only baseline DI and sex was excellent with ROC AUC of 0.9313 for lcSSc and 0.9027 for dcSSc. Using this model, we determined whether patients would fall into 'good' or 'bad' trajectory groups and then plotted their actual trajectories which showed clear differences between the predicted 'good' and 'bad' cases in both derivation and validation cohorts. CONCLUSIONS: A simple model using only cutaneous subset, baseline DI and sex can predict damage accumulation in early SSc.

Authors 36

1. Murray G Baron corresponding

   Lady Davis Institute for Medical Research

   Affiliation as printed

   Lady Davis Institute for Medical Research , Montreal, Quebec, Canada

2. Ariane Barbacki

   Lady Davis Institute for Medical Research

   Affiliation as printed

   Lady Davis Institute for Medical Research , Montreal, Quebec, Canada

3. Ada Man

   University of Manitoba

   Affiliation as printed

   Rheumatology, Faculty of Medicine, University of Manitoba , Winnipeg, Manitoba, Canada

4. Jeska Kirsten De Vries-Bouwstra Aachen Department of Rheumatology, Leiden University

   Leiden University

   Affiliation as printed

   Department of Rheumatology, Leiden University , Leiden, The Netherlands

5. Wendy Stevens

   St Vincent's Hospital Melbourne

   Affiliation as printed

   Division of Rheumatology, St. Vincent’s Hospital Melbourne , Fitzroy, Victoria, Australia

6. Mohammed S. Osman

   University of Alberta

   Affiliation as printed

   Department of Medicine, University of Alberta , Edmonton, Alberta, Canada

7. Mianbo Wang

   Lady Davis Institute for Medical Research

   Affiliation as printed

   Lady Davis Institute for Medical Research , Montreal, Quebec, Canada

8. Yuqing Zhang

   Harvard University · Massachusetts General Hospital

   Affiliation as printed

   Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School , Boston, MA, USA

9. Joanne Sahhar

   Monash Health

   Affiliation as printed

   Monash Health , Clayton, Victoria, Australia

10. Gene‐Siew Ngian

    Monash Health

    Affiliation as printed

    Monash Health , Clayton, Victoria, Australia

11. Susanna Proudman

    Royal Adelaide Hospital · The University of Adelaide

    Affiliation as printed

    Discipline of Medicine, University of Adelaide , Adelaide, South Australia, Australia

    Royal Adelaide Hospital , Adelaide, South Australia, Australia

12. Mandana Nikpour

    University of Alberta · The University of Melbourne · St Vincent's Hospital Melbourne

    Affiliation as printed

    Department of Medicine, University of Alberta , Edmonton, Alberta, Canada

    University of Melbourne at St-Vincent Hospital , Melbourne, Fitzroy, Victoria, Australia

13. Geneviève Gyger
14. Sophie Ligier
15. Janet Elizabeth Pope
16. MAGGIE J. LARCHÉ
17. NADER A. KHALIDI
18. A Massetto
19. Emily J. Sutton
20. T.S. Rodríguez-Reyna
21. Carter Thorne
22. Paul R. Fortin
23. Alena Ikic
24. David W. Robinson
25. Nicola Jones
26. SHARON A. LECLERCQ
27. Maysan Abu-Hakima
28. Elżbieta Kamińska
29. Marvin J. Fritzler
30. Nava Ferdowsi
31. Kathleen Morrisroe
32. Laura Ross
33. Jennifer G. Walker
34. Janet Roddy
35. Lauren Host
36. Gabor A. C. Major