Mouth opening in systemic sclerosis: A longitudinal analysis from the French National Cohort Study.

disease severity mouth opening prognosis survival systemic sclerosis

Journal

Journal of internal medicine
ISSN: 1365-2796
Titre abrégé: J Intern Med
Pays: England
ID NLM: 8904841

Informations de publication

Date de publication:
27 Jun 2023
Historique:
pubmed: 28 6 2023
medline: 28 6 2023
entrez: 28 6 2023
Statut: aheadofprint

Résumé

Few studies have evaluated mouth opening (MO) in systemic sclerosis (SSc). None have studied MO trajectories. To study MO trajectories in SSc. This multicentre study included patients enrolled in the French national SSc cohort with at least one MO assessment, described patients based on MO baseline measure, modeled MO trajectories, and associated MO measures with SSc prognosis. We included 1101 patients. Baseline MO was associated with disease severity. On Kaplan-Meier analysis, MO < 30 mm was associated with worse 30-year-survival (p<0.01) and risk of pulmonary arterial hypertension (p<0.05). Individual MO trajectories were heterogenous among patients. The best model of MO trajectories according to latent-process mixed modeling showed that 88.8% patients had a stable MO trajectory and clustered patients into 3 groups that predicted SSc survival (p<0.05) and interstitial lung disease (ILD) occurrence (p<0.05). The model highlighted a cluster of 9.5% patients with diffuse cutaneous SSc (dcSSc) (p<0.05) and high but decreasing MO over 1 year (p<0.0001) who were at increased risk of poor survival and ILD. MO, which is a simple and reliable measure, could be used to predict disease severity and survival in SSc. Although MO remained stable in most SSc patients, dcSSc patients with high but decreasing MO were at risk of poor survival and ILD. This article is protected by copyright. All rights reserved.

Sections du résumé

BACKGROUND BACKGROUND
Few studies have evaluated mouth opening (MO) in systemic sclerosis (SSc). None have studied MO trajectories.
OBJECTIVE OBJECTIVE
To study MO trajectories in SSc.
METHODS METHODS
This multicentre study included patients enrolled in the French national SSc cohort with at least one MO assessment, described patients based on MO baseline measure, modeled MO trajectories, and associated MO measures with SSc prognosis.
RESULTS RESULTS
We included 1101 patients. Baseline MO was associated with disease severity. On Kaplan-Meier analysis, MO < 30 mm was associated with worse 30-year-survival (p<0.01) and risk of pulmonary arterial hypertension (p<0.05). Individual MO trajectories were heterogenous among patients. The best model of MO trajectories according to latent-process mixed modeling showed that 88.8% patients had a stable MO trajectory and clustered patients into 3 groups that predicted SSc survival (p<0.05) and interstitial lung disease (ILD) occurrence (p<0.05). The model highlighted a cluster of 9.5% patients with diffuse cutaneous SSc (dcSSc) (p<0.05) and high but decreasing MO over 1 year (p<0.0001) who were at increased risk of poor survival and ILD.
CONCLUSION CONCLUSIONS
MO, which is a simple and reliable measure, could be used to predict disease severity and survival in SSc. Although MO remained stable in most SSc patients, dcSSc patients with high but decreasing MO were at risk of poor survival and ILD. This article is protected by copyright. All rights reserved.

Identifiants

pubmed: 37376708
doi: 10.1111/joim.13689
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

This article is protected by copyright. All rights reserved.

Auteurs

Benjamin Chaigne (B)

Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Ile de France, France.
APHP-CUP, Hôpital Cochin, F-75014 Paris, Université Paris Cité, France.

Alexandre Bense (A)

Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Ile de France, France.
APHP-CUP, Hôpital Cochin, F-75014 Paris, Université Paris Cité, France.

Christian Agard (C)

CHU Nantes, Service de Médecine interne, Nantes Université, Nantes, France.

Yannick Allanore (Y)

Rheumatology Department, Cochin hospital, Paris Cité University, Paris, France.

Grégory Pugnet (G)

Centre Hospitalier Universitaire, Medecine Interne, Toulouse, France.

Eric Hachulla (E)

Université de Lille, INSERM, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Autoimmunes Systémiques Rares Du Nord et Nord-Ouest de France, France.

Jérôme Avouac (J)

Rheumatology Department, Cochin hospital, Paris Cité University, Paris, France.

Boris Bienvenu (B)

Service de Médecine Interne, Centre Hospitalier National Ophtalmologique des 15-20, Paris.

Sylvain Palat (S)

CHU Limoges, Limoges, Limousin, France.

Claire Grange (C)

Department of Internal Medicine, Lyon Sud University Hospital, Lyon, France.

Sabine Berthier (S)

Department of internal medicine, University hospital of Dijon, Dijon, France.

Emmanuel Chatelus (E)

Rheumatology, Hôpitaux universitaires de Strasbourg, Strasbourg, France.

Sébastien Rivière (S)

Service de Médecine Interne and Inflammation-Immunopathology, Biotherapy Department (DMU 3iD), Sorbonne Université, Hôpital Saint-Antoine, AP-HP, Paris, 75012, France.

Marie-Elise Truchetet (ME)

Rheumatology Department, University Hospital of Bordeaux, Centre de Référence des Maladies Autoimmunes Systémiques Rares Du Sud-Ouest, Bordeaux, France.

Jean-Emmanuel Kahn (JE)

Department of Internal Medicine, Hôpital Ambroise-Paré, Boulogne-Billancourt, France.

Francois Maurier (F)

Department of Internal Medicine and Clinical Immunology, Hôpital Robert Schuman, Metz-Vantoux, 57070, France.

Elisabeth Diot (E)

Department of Internal Medicine and Clinical Immunology, University Hospital of Tours, Tours, France.

Alice Berezne (A)

Department of Internal Medicine and Infectious Diseases, CHR Annecy-Genevois Annecy France, France.

Luc Mouthon (L)

Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Ile de France, France.
APHP-CUP, Hôpital Cochin, F-75014 Paris, Université Paris Cité, France.
Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Ile de France, France.

Classifications MeSH