Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2014 Nov;66(11):1731-9.
doi: 10.1002/acr.22339.

Correlates and responsiveness to change of measures of skin and musculoskeletal disease in early diffuse systemic sclerosis

Alexandra B Wiese  1 , Veronica J Berrocal, Daniel E Furst, James R Seibold, Peter A Merkel, Maureen D Mayes, Dinesh Khanna
Affiliations
Observational Study

Correlates and responsiveness to change of measures of skin and musculoskeletal disease in early diffuse systemic sclerosis

Alexandra B Wiese et al. Arthritis Care Res (Hoboken). 2014 Nov.

Abstract

Objective: Skin and musculoskeletal involvement are frequently present early in diffuse cutaneous systemic sclerosis (dcSSc). The current study examined the correlates for skin and musculoskeletal measures in a 1-year longitudinal observational study.

Methods: Patients with dcSSc were recruited at 4 US centers and enrolled in a 1-year study. Prespecified and standardized measures included physician and patient assessments of skin involvement, modified Rodnan skin score (MRSS), durometer score, Health Assessment Questionnaire disability index, serum creatine phosphokinase, tender joint counts, and presence/absence of tendon friction rubs, small joint contractures, and large joint contractures. Additionally, physician and patient global health assessments and health-related quality of life assessments were recorded. Correlations were computed among the baseline global assessments, skin variables, and musculoskeletal variables. Using the followup physician and patient anchors, effect sizes were calculated.

Results: A total of 200 patients were studied: 75% were women, mean ± SD age was 50.0 ± 11.9 years, and mean ± SD disease duration from first non-Raynaud's phenomenon symptom was 1.6 ± 1.4 years. Physician global health assessment had large correlations with MRSS (r = 0.60) and physician-reported skin involvement visual analog scale in the last month (r = 0.74), whereas patient global assessment had large correlations with MRSS, the Short Form 36 health survey physical component scale, skin interference, and skin involvement in the last month (r = 0.37-0.72). Four of 9 skin variables had moderate to large effect sizes (0.51-1.09).

Conclusion: Physician and patient global assessments have larger correlations with skin measures compared to musculoskeletal measures. From a clinical trial perspective, skin variables were more responsive to change than musculoskeletal variables over a 1-year period, although both provide complementary information.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Pairwise scatterplot of modified Rodnan skin scores and durometer scores (correlation: r = 0.69).
See this image and copyright information in PMC

References

    1. Subcommittee for Scleroderma Criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Preliminary criteria for the classification of systemic sclerosis (scleroderma) Arthritis Rheum. 1980;23:581–590. - PubMed
    1. LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA, et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol. 1988;15:202–205. - PubMed
    1. Mura G, Bhat KM, Pisano A, Licci G, Carta M. Psychiatric symptoms and quality of life in systemic sclerosis. Clin Pract Epidemiol Ment Health. 2012;8:30–35. - PMC - PubMed
    1. Danieli E, Airo P, Bettoni L, Cinquini M, Antonioli CM, Cavazzana I, et al. Health-related quality of life measured by the Short-Form 36 (SF-36) in systemic sclerosis: correlations with indexes of disease activity and severity, disability, and depressive symptoms. Clin Rheumatol. 2005;24:48–54. - PubMed
    1. Del Rosso A, Boldrini M, D’Agostino D, Placidi GP, Scarpato A, Pignone A, et al. Health-related quality of life in systemic sclerosis as measured by the Short Form 36: relationship with clinical and biologic markers. Arthritis Rheum. 2004;51:475–481. - PubMed

Publication types

MeSH terms

Substances