Longitudinal association between nailfold capillaroscopy and incident interstitial lung disease: A EUSTAR database analysis

Journal of Scleroderma and Related Disorders, vol. 10, pp. 368–376

Abstract

Objectives: To evaluate (1) the association between nailfold capillaroscopy pattern and 5-year risk for incident interstitial lung disease and (2) the association between transition in nailfold capillaroscopy pattern and risk of incident interstitial lung disease. Methods: Data of adult patients from the EUSTAR database fulfilling the ACR-EULAR criteria with a disease duration ⩽5 years, having a scleroderma pattern at nailfold capillaroscopy with high-resolution computed tomography confirmed absence of interstitial lung disease (i.e. baseline) was used. Interstitial lung disease-free survival was assessed for up to 5 years of follow-up with a Cox proportional hazards model stratified on nailfold capillaroscopy pattern at baseline. The association of annual transition in nailfold capillaroscopy pattern on the risk to develop interstitial lung disease was assessed with a mixed logistic regression analysis. Results: Out of 771 eligible patients, 283 (37%) had an early pattern, 377 (49%) had an active pattern, and 111 (14%) had a late pattern. The Cox proportional hazard model including the identified confounders did not show an association between severity of nailfold capillaroscopy pattern at baseline and increased risk for interstitial lung disease during 5-year follow-up (hazard ratio (95 confidence interval; p value): 1.09 (0.86-1.39; 0.47)). The mixed logistic regression analysis revealed an increased annual risk for incident interstitial lung disease with increasing severity of capillaroscopic pattern (odds ratio (95% confidence interval); p value 3.76 (1.99-7.11; <0.01)). Conclusion: Our study shows that worsening of nailfold capillaroscopy has a strong association with an increased annual risk to develop interstitial lung disease. Of note, a worse scleroderma pattern at nailfold capillaroscopy is not associated with the long-term risk to develop interstitial lung disease.

Authors 16

1. Arthiha Velauthapillai

   Radboud University Medical Center

   Affiliation as printed

   Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands

2. Jeska Kirsten De Vries-Bouwstra Aachen Department of Rheumatology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands

3. Jörg Henes

   Universitätsklinikum Tübingen · University of Tübingen

   Affiliation as printed

   Center for Interdisciplinary Rheumatology, Immunology and Autoimmune Diseases, Department for Internal Medicine II (Hematology, Oncology, Rheumatology and Clinical Immunology), University Hospital Tuebingen, Tuebingen, Germany

4. László Czirják

   University of Pecs

   Affiliation as printed

   Medical Center, Department of Rheumatology and Immunology, University of Pecs, Pecs, Hungary

5. Lorenzo Dagna

   Vita-Salute San Raffaele University · IRCCS Ospedale San Raffaele

   Affiliation as printed

   Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy

   Vita-Salute San Raffaele University, Milan, Italy

6. Gabriela Riemekastan

   University of Lübeck

   Affiliation as printed

   Department of Rheumatology and Clinical Immunology, University of Medical Center Schleswig-Holstein, University Lübeck, Lübeck, Germany

7. Yannick Allanore

   Université Paris Cité · Hôpital Cochin · Assistance Publique – Hôpitaux de Paris

   Affiliation as printed

   Department of Rheumatology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Université Paris Cité, Paris, France

8. Rosario Foti

   University of Catania · Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco"

   Affiliation as printed

   Rheumatology Unit A.O.U. Policlinico S. Marco, Catania, Italy

9. Juan José Alegre Sancho

   Hospital Universitario Doctor Peset

   Affiliation as printed

   Department of Rheumatology, Hospital Universitario Doctor Peset, Valencia, Spain

10. Britta Maurer

    University of Bern · University Hospital of Bern

    Affiliation as printed

    Department of Rheumatology & Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Lung Precision Medicine (LPM), Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland

11. Giovanna Cuomo

    University of Campania "Luigi Vanvitelli"

    Affiliation as printed

    UOC Rheumatology, Department Of Precision Medicine, University of Campania Luigi Vanvitelli, Napoli, Italy

12. Julia Spierings

    Utrecht University · University Medical Center Utrecht

    Affiliation as printed

    Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands

13. Thierry Martin

    Hôpitaux Universitaires de Strasbourg · ERN ReCONNET

    Affiliation as printed

    Department of Rheumatology & Clinical Immunology, National Reference Center for Rare Systemic Autoimmune Diseases, ERN ReCONNET, Strasbourg University Hospital, Strasbourg, France

14. Marie‐Elise Truchetet

    Centre National de la Recherche Scientifique · Université de Bordeaux · Centre Hospitalier Universitaire de Bordeaux · Immunology from Concept and Experiments to Translation

    Affiliation as printed

    CNRS UMR 5164, ImmunoConcEpT, University of Bordeaux, Bordeaux, France

    FHU ACRONIM, Centre National de référence Des Maladies Autoimmunes et Systémiques Rares Est/Sud-Ouest (RESO), CHU de Bordeaux, Bordeaux, France

15. Cornelia H. M. van den Ende

    Radboud University Medical Center

    Affiliation as printed

    Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands

16. Madelon C Vonk

    Radboud University Medical Center

    Affiliation as printed

    Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands