Evaluation of Patient and Physician Assessments of Gastrointestinal Disease Activity in Systemic Sclerosis

Objective. To assess whether patient and physician global assessment of gastrointestinal tract (GIT) disease in systemic sclerosis (SSc) are associated with a meaningful change in disease status.Methods. One hundred forty-three participants from the Australian Scleroderma Cohort Study were recruited to this study. Using logistic regression analysis, we evaluated the relationship between patient-reported and physician-assessed GIT disease status and symptoms, measures of health-related quality of life (36-item Short Form Health Survey [SF-36]) and GIT disease severity, measured by the Scleroderma Clinical Trials Consortium UCLA Gastrointestinal Tract 2.0 (GIT 2.0) score.Results. Patient-reported worsening of GIT symptoms in the month preceding assessment was significantly associated with more severe GIT disease (odds ratio [OR] 6.14, P < 0.01) and progressive worsening GIT disease severity as measured by the GIT 2.0 score (OR 45.98, P < 0.01). The new onset of reflux was the only specific symptom associated with patient-reported GIT disease activity (OR 2.98, P = 0.04). Physician -assessed GIT disease activity was not significantly associated with higher GIT 2.0 scores or increasing severity of disease. Patient-reported and physician-assessed GIT activity was not associated with SF-36 scores.Conclusion. In the absence of objective measures of GIT disease activity in SSc, patient-reported symptoms of GIT disease could be used to indicate disease activity and should merit consideration for inclusion in a multisystem disease activity index.

Automated summary

This study aimed to evaluate whether patient and physician global assessment of gastrointestinal tract (GIT) disease in systemic sclerosis (SSc) are linked to a meaningful change in disease status. Logistic regression analysis was used to assess the relationship between patient-reported and physician-assessed GIT disease status and symptoms, quality of life measures, and GIT disease severity. The study found that patient-reported worsening of GIT symptoms was associated with more severe GIT disease, while physician-assessed GIT disease activity was not significantly associated with disease severity or quality of life scores.