Persistent inflammation in systemic sclerosis is strongly associated with mortality: a EUSTAR database analysis

C‐reactive protein as a candidate biomarker in fibrotic interstitial lung disease

“…In a recent study from the European Scleroderma Trials and Research (EUSTAR) that included 1171 patients with SSc‐ILD who had at least three CRP measurements available during follow‐up, a persistent inflammatory phenotype, defined as CRP level ≥5 mg/L at ≥80% of visits, was associated with a 6.7 times greater risk of mortality within 5 years as compared with patients with a persistent non‐inflammatory phenotype defined by CRP level ≥5 mg/L at <20% of visits 19 . Persistent inflammation was an important risk factor for early mortality, independent from demographics, cutaneous phenotype, baseline pulmonary function and immunosuppressive treatment 19 . However, the data from SSc‐ILD cannot yet be extrapolated to ILDs at large.…”

“…19 Persistent inflammation was an important risk factor for early mortality, independent from demographics, cutaneous phenotype, baseline pulmonary function and immunosuppressive treatment. 19 However, the data from SSc-ILD cannot yet be extrapolated to ILDs at large. Whether the persistence of elevated CRP levels during follow-up may be associated with increased mortality in fHP, RA-ILD or even IPF needs to be explored.…”

Interstitial Lung Disease Associated with Systemic Sclerosis

“…Interestingly, SSc patients with a persistent inflammatory phenotype, characterized by persistently elevated C-reactive protein levels (!5 mg/L), showed features of more severe ILD and had a six-fold increased risk of mortality within 5 years of the start of the study. 80,81 Repeated measurement of a biomarker, such as C-reactive protein, could improve not only risk stratification, but also monitoring of treatment response and modification of treatment plans for patients with SSc. 80 Increased C-reactive protein level contributes to identifying patients with a high risk of ILD progression, especially if carrying anti-Scl70 antibodies, in whom initiation of immunosuppressive therapy may be warranted without waiting for disease progression.…”

“…80,81 Repeated measurement of a biomarker, such as C-reactive protein, could improve not only risk stratification, but also monitoring of treatment response and modification of treatment plans for patients with SSc. 80 Increased C-reactive protein level contributes to identifying patients with a high risk of ILD progression, especially if carrying anti-Scl70 antibodies, in whom initiation of immunosuppressive therapy may be warranted without waiting for disease progression. 1,80…”

ERS International Congress 2022: highlights from the Interstitial Lung Diseases Assembly

“…This phenotype was associated with a more than five times higher risk of mortality independent of demographics, SSc subset, treatment, and pulmonary function. Repetitive CRP measurements might facilitate therapeutic decisions and estimation of prognosis 21 . In the EUSTAR cohort, the mean FVC change in SSc-ILD patients over the first 12 months was -0.1 %.…”