Increased risk of mortality in systemic sclerosis-associated digital ulcers: a systematic review and meta-analysis.


Journal

Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037

Informations de publication

Date de publication:
Feb 2019
Historique:
received: 22 03 2018
accepted: 30 05 2018
pubmed: 12 6 2018
medline: 7 6 2019
entrez: 12 6 2018
Statut: ppublish

Résumé

Survival can be threatened in certain forms of systemic sclerosis (SSc) so clear prognostic factors are needed. The aim of this meta-analysis was to assess the association between the presence of digital ulcers (DUs) and mortality in SSc. We performed a systematic review and meta-analysis in the Pubmed and Scopus databases from the earliest records to May 2017. Two research strategies were performed: « systemic sclerosis » and « digital ulcers » (strategy A); « systemic sclerosis » and « mortality » (strategy B). The primary outcome was the mortality associated with the presence of DUs in patients with SSc. The literature search identified 1473 citations. Fifty-nine studies were examined for full text. Ten articles were included for the meta-analysis. SSc patients with DUs had an increased pooled mortality risk: RR = 1.53 (IC 95%: [1.23-1.90]). This meta-analysis revealed a higher mortality in SSc patients with associated DUs. Having DUs may be a predictive factor of developing organ involvement such as pulmonary or cardiovascular events that could be associated with poor survival. It suggests that early screening of DUs in SSc patients is important to identify patients most at risk of poor survival.

Sections du résumé

BACKGROUND BACKGROUND
Survival can be threatened in certain forms of systemic sclerosis (SSc) so clear prognostic factors are needed.
OBJECTIVES OBJECTIVE
The aim of this meta-analysis was to assess the association between the presence of digital ulcers (DUs) and mortality in SSc.
METHODS METHODS
We performed a systematic review and meta-analysis in the Pubmed and Scopus databases from the earliest records to May 2017. Two research strategies were performed: « systemic sclerosis » and « digital ulcers » (strategy A); « systemic sclerosis » and « mortality » (strategy B). The primary outcome was the mortality associated with the presence of DUs in patients with SSc.
RESULTS RESULTS
The literature search identified 1473 citations. Fifty-nine studies were examined for full text. Ten articles were included for the meta-analysis. SSc patients with DUs had an increased pooled mortality risk: RR = 1.53 (IC 95%: [1.23-1.90]).
CONCLUSIONS CONCLUSIONS
This meta-analysis revealed a higher mortality in SSc patients with associated DUs. Having DUs may be a predictive factor of developing organ involvement such as pulmonary or cardiovascular events that could be associated with poor survival. It suggests that early screening of DUs in SSc patients is important to identify patients most at risk of poor survival.

Identifiants

pubmed: 29888406
doi: 10.1111/jdv.15114
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

405-409

Informations de copyright

© 2018 European Academy of Dermatology and Venereology.

Auteurs

P Meunier (P)

Department of Rheumatology, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France.

L Dequidt (L)

Department of Dermatology and Paediatric Dermatology, National Reference Center for Rare Skin Diseases, Saint-André Hospital, University Hospital of Bordeaux, Bordeaux, France.

T Barnetche (T)

Department of Rheumatology, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France.

E Lazaro (E)

Immunology Laboratory, ImmunoConcept, UMR CNRS 5164, University Hospital of Bordeaux, Bordeaux, France.
Department of Internal Medicine, Haut-Lévêque, University Hospital of Bordeaux, Pessac, France.

P Duffau (P)

Immunology Laboratory, ImmunoConcept, UMR CNRS 5164, University Hospital of Bordeaux, Bordeaux, France.
Department of Internal Medicine, Saint-André Hospital, University of Bordeaux, Bordeaux, France.

C Richez (C)

Department of Rheumatology, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France.
Immunology Laboratory, ImmunoConcept, UMR CNRS 5164, University Hospital of Bordeaux, Bordeaux, France.

L Couzi (L)

Department of Nephrology, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France.

M-E Truchetet (ME)

Department of Rheumatology, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France.
Immunology Laboratory, ImmunoConcept, UMR CNRS 5164, University Hospital of Bordeaux, Bordeaux, France.

J Seneschal (J)

Department of Dermatology and Paediatric Dermatology, National Reference Center for Rare Skin Diseases, Saint-André Hospital, University Hospital of Bordeaux, Bordeaux, France.

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Classifications MeSH