Journal
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY
Volume 39, Issue 4, Pages S142-S148Publisher
CLINICAL & EXPER RHEUMATOLOGY
Keywords
systemic sclerosis; gastrointestinal tract; prevention immunosuppression
Categories
Funding
- Canadian Institutes of Health Research (CIHR), Scleroderma Canada
- Scleroderma Society of Ontario, Sclerodermie Quebec
- Scleroderma Association of Saskatchewan, Scleroderma Manitoba
- Scleroderma Society of Nova Scotia
- Scleroderma Association of British Columbia
- Cure Scleroderma Foundation
- Canadian Blood and Marrow Transplant Group
- Lady Davis Institute of Medical Research of the Jewish General Hospital, Montreal, QC
- Actelion Pharmaceuticals
- Scleroderma Australia
- Scleroderma Victoria
- Arthritis Australia
- Actelion Australia
- Janssen Australia
- Musculoskeletal Australia
- Australian Rheumatology Association
- Scleroderma Clinical Trials Consortium
- St Vincent's Hospital Research Endowment Fund
- Bayer
- GlaxoSmithKline Australia
- Mallinckrodt
Ask authors/readers for more resources
The study found that exposure to immunosuppression in early systemic sclerosis patients did not modify the risk of developing severe gastrointestinal involvement.
Objective. We aimed to test the hypothesis that exposure to inununosuppression in early systemic sclerosis (SSc) could modify the risk of developing new onset severe gastrointestinal (GIT) involvement. Methods. A total of 762 subjects with <3 years of disease duration and without severe GIT disease at baseline study visit were identified front combined longitudinal cohort data from the Canadian Scleroderma Research Group (CSRG) and Australian Scleroderma Interest Group (ASIG). The primary exposure was ever use of methotrexate, cyclophosphamide, mycophenolate mofetil and/or azathioprine during the study period. Severe GIT disease was defined as: 1-malabsorption, 2-hyperalintentation, 3-pseudo-obstruction, and/or 4->= 10% weight loss in association with the use of antibiotics for bacterial overgrowth or oesophageal stricture. The change in the hazard of severe GIT disease due to exposure was estimated using a marginal structural Cox proportional hazards model fit by inverse probability of treatment weights (IPTW) to address potential confounding. Results. Study subjects were 81.5% female, had a mean age of 53 .7 +/- 13 .0 years and mean disease duration at baseline of 1.4 +/- 0.8 years. During a mean follow-up of 4.0 +/- 2 .6 years, severe GIT involvement developed in 11.6% of the 319 subjects exposed to immunosuppression and in 6.8% of the 443 unexposed subjects. In an IPTW-adjusted analysis, exposure to immunosuppression was not associated with severe GIT disease (weighted hazard ratio 0.91, 95% confidence interval 052-158). Conclusion. In this large inception SSc cohort, the risk of severe GIT involvement was not modified by exposure to immunosuppression.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available