Comorbidity burden in systemic sclerosis: beyond disease-specific complications

Pagkopoulou, Eleni; Arvanitaki, Alexandra; Daoussis, Dimitrios; Garyfallos, Alexandros; Kitas, George D.; Dimitroulas, Theodoros

doi:10.1007/s00296-019-04371-z

Cited by 26 publications

(15 citation statements)

References 102 publications

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“…There were strong correlations between the PHQ-8 Swe and pain/bodily pain, fatigue/vitality, physical role function, social function, and mental health, indicating that the PHQ-8 Swe for individuals with SSc reflects both physical and mental aspects. The medical treatment indicates that pain was a problem in our sample, which the strong correlation between pain and PHQ-8 Swe also implies, an association in agreement with previous reports [ 45 ]. Our results align with those of other studies indicating that symptoms of depression are associated with decreased HRQL more than with organ manifestations that may be life-threatening [ 8 ].…”

Section: Discussionsupporting

confidence: 93%

Validity and reliability of the Patient Health Questionnaire-8 in Swedish for individuals with systemic sclerosis

et al. 2020

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Background Depressive symptoms are common in rheumatic diseases and influence patients’ quality of life. The Patient Health Questionnaire-9 (PHQ-9), which assesses symptoms of depression, is valid in English in patients with systemic sclerosis (SSc). However, the measurement properties of the PHQ-8 (short version of the PHQ-9) have not been evaluated in Swedish patients with SSc. Objective To investigate different aspects of validity and reliability of the PHQ-8 in Swedish (PHQ-8 Swe) for individuals with SSc. Methods A total of 101 patients with SSc participated. Content validity was evaluated via interviews of 11 patients and 10 health professionals. Construct validity, internal consistency test–retest reliability, and floor/ceiling effects were evaluated in 90 patients. Results Content validity was satisfactory, but some linguistic adjustments were made. Confirmatory factor analysis supported a better fit for a two-factor structure. Moderate-to-strong correlations were found between the PHQ-8 Swe and scleroderma HAQ including VAS ( r s = 0.4–0.7); Multidimensional Assessment of Fatigue ( r s = 0.7); RAND-36 subscales ( r s = − 0.5 to − 0.8); and lung disease severity (Medsger scores) ( r s = 0.4). There were weak correlations ( r s = <0.4) between the PHQ-8 Swe and modified Rodnan skin score; and vascular, heart, and kidney disease severity. Cronbach’s alpha was 0.85, corrected item-to-total correlations were >0.40, and the ICC for the total score was 0.83. No floor/ceiling effects were found. Conclusion The PHQ-8 Swe has satisfactory content validity and sufficient reliability in patients with in majority limited SSc. It is more strongly associated with self-reported disability, pain, disease interferences with daily activities, fatigue, and quality of life than with disease severity, except for a moderate association with lung severity.

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Section: Discussionsupporting

confidence: 93%

Validity and reliability of the Patient Health Questionnaire-8 in Swedish for individuals with systemic sclerosis

et al. 2020

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“… 1 Patients with SSc are more likely to predispose to pulmonary infection owing to host susceptibility factors such as (i) the underlying autoimmune disease itself, (ii) aspiration risks due to oesophageal dysfunction, (iii) treatment with immune‐modulating agents and (iv) respiratory muscle weakness. 10 , 11 Thus, these patients are more vulnerable to opportunistic tuberculosis or aspergillosis. Although Aspergillus can grow in any pre‐existing cavity or bullous lung lesion, such association with SSc is very uncommon in clinical practice and is rarely reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…An internal solid component with diffuse and coarse calcification was found in a dependent position suggesting a fungal ball respiratory muscle weakness. 10,11 Thus, these patients are more vulnerable to opportunistic tuberculosis or aspergillosis. Although Aspergillus can grow in any pre-existing cavity or bullous lung lesion, such association with SSc is very uncommon in clinical practice and is rarely reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Systemic sclerosis‐associated interstitial lung disease in a Vietnamese adult female: Case report and literature review

Nguyễn

Thanh

2021

Respirology Case Reports

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Systemic sclerosis‐associated interstitial lung disease (SSc‐ILD) is a rare disease in the Asian population and might be overlooked in clinical practice. Early diagnosis is crucial to initiate treatment and to prevent disease progression. Chest high‐resolution computed tomography (HRCT) is the modality of choice for diagnosing and assessing this disorder. SSc‐ILD should be included in the list of differential diagnoses of ILD. Familiarity with HRCT findings and thorough clinical examination are crucial for diagnosis and treatment.

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“…A study with the online databases such as MEDLINE and EMBASE until December 2018 showed the comorbidities including atherosclerosis and CAD, dyslipidaemia, infections, cancer, psychological burden and osteoporosis in SSc. 38 Second, several studies have proposed potential reasons for endothelial dysfunction, atherosclerosis and vasculopathy in patients with SSc, including downregulated endothelial nitric oxide synthase and increased endothelial microparticle-associated diminished nitric oxide synthesis 39 40 elevated oxidised low-density lipoprotein and endothelin 41 and increased inflammatory mediators, including tumour necrosis factor-alpha and interleukin-6. 42 Additionally, Boin et al proposed that the antibody anti-β2-glycoprotein I is associated with PAD in patients with SSc.…”

Section: Discussionmentioning

confidence: 99%

Association between systemic sclerosis and peripheral arterial disease: a nationwide observation retrospective claim records cohort study in Taiwan

Hsieh¹,

Chen

Chou

et al. 2021

BMJ Open

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ObjectivesRecent studies have proposed associations between systemic sclerosis (SSc) and atherosclerosis and between SSc and cardiovascular disease. However, in Asia, no large-scale studies have focused on the association between peripheral arterial disease (PAD) and SSc.SettingA nationwide observation retrospective cohort study.ParticipantsThe National Health Insurance Research Database was used for selecting patients diagnosed with SSc from 2000 to 2011. Patients diagnosed with PAD before the index date were excluded.Primary and secondary outcome measuresThe SSc cohort comprised 1106 patients with SSc, and the non-SSc cohort comprised 4424 matched controls. The Cox proportional hazards regression model was used for analysing the adjusted risk of PAD between the case and control patients.ResultsThe SSc cohort exhibited a significantly higher risk (HR=2.15, 95% CI=1.47 to 3.14) of PAD than did the non-SSc cohort. Patients with heart failure exhibited the highest risk of PAD (adjusted HR=2.10, 95% CI=1.20 to 3.70). Moreover, even without any comorbidities, the SSc cohort exhibited a significantly higher risk (adjusted HR=4.17 fold, 95% CI=1.98 to 8.77) of PAD than did the non-SSc cohort.ConclusionSSc is associated with a significantly high risk of PAD. Further studies are required to reduce the PAD risk among patients with SSc.

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Comorbidity burden in systemic sclerosis: beyond disease-specific complications

Cited by 26 publications

References 102 publications

Validity and reliability of the Patient Health Questionnaire-8 in Swedish for individuals with systemic sclerosis

Validity and reliability of the Patient Health Questionnaire-8 in Swedish for individuals with systemic sclerosis

Systemic sclerosis‐associated interstitial lung disease in a Vietnamese adult female: Case report and literature review

Association between systemic sclerosis and peripheral arterial disease: a nationwide observation retrospective claim records cohort study in Taiwan

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