Systemic sclerosis & Raynaud's
Immunosuppressive therapy to treat newly diagnosed primary heart involvement in patients with systemic sclerosis: An Italian cardiac magnetic resonance based study
Authors' conclusion
Our data show that immunosuppression is a therapeutic strategy which has the potentiality to treat newly diagnosed SSc-pHI, by curbing signs of myocardial inflammation at CMR, and by significantly reducing cardiac enzymes, inflammatory markers and overall clinical burden.
Study context
- Population
- Systemic sclerosis (SSc) patients with cardiac magnetic resonance (CMR)-proven primary heart involvement who started or modified immunosuppressive therapy for newly diagnosed primary heart involvement (pHI)from a cohort of 684 SSc patients
- Participants
- 35 patients
- Exposure
- Follow-up CMR vs baseline CMR after immunosuppressive therapy
- Outcome
- Active myocardial inflammation on CMR
- Follow-up
- Median 12.0 [6.5-16.0] months
Methodological detailsbefore–after (baseline vs follow-up CMR), Median duration of immunosuppression 12.0 [6.0-15.5] months, Immunosuppression: Mycophenolate mofetil (MMF) started in 15 (42.9 %) or increased in 7 (20.0 %); RTX 7 (20.0 %); AZA 3 (8.6 %); 1 each CYC (with pulse steroids), tocilizumab, HCQ (with steroids)
- Before–after (baseline vs follow-up CMR)
- Median duration of immunosuppression 12.0 [6.0-15.5] months
- Immunosuppression: MMF started in 15 (42.9 %) or increased in 7 (20.0 %); RTX 7 (20.0 %); AZA 3 (8.6 %); 1 each CYC (with pulse steroids), tocilizumab, HCQ (with steroids)
Main finding
As reported in the abstract
P = 0.003
Observational data: associations, not effects.
Further findings
T2-mapping
P < 0.001
Native-T1-mapping
P = 0.022
T2-mapping (baseline increased mapping subgroup)
P < 0.0001 for both
T1-mapping (baseline increased mapping subgroup)
P < 0.0001 for both
ECV
P = 0.041
| Outcome | Baseline | Follow-up | P value |
|---|---|---|---|
| Edema at STIR · follow-up | — not stated in the abstract | 14.3 % | P = 0.002 |
— not stated in the abstract
NT-proBNP, high-sensitive troponin T and CRP
- Significant reduction of NT-proBNP
- P = 0.008
- Significant reduction of high-sensitive troponin T
- P = 0.003
- Significant reduction of CRP
- P = 0.010
Safety
- No treatment-related adverse events were recorded
Original publication
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