Systemic sclerosis & Raynaud's
Impact of Evolving Treatment Patterns on Interstitial Lung Disease Progression in Systemic Sclerosis Using the European Scleroderma Trials and Research Database
Authors' conclusion
Our findings reveal a significant evolution in clinical practice.
Study context
- Population
- Patients with SSc-ILD meeting the 2013 ACR/EULAR criteria with high-resolution CT-confirmed ILD, pulmonary function and therapy data, EUSTAR database
- Participants
- 1,409 patients
- Exposure
- Treatment patterns and ILD progression across four time periods
- Outcome
- Treatment trends (IST initiation, switching, discontinuation, combination therapy) and ILD progression (decline in % predicted FVC ≥5% or % predicted DLCO ≥10%)
- Follow-up
- 12 ± 3 months
Methodological detailsmulticentre registry (EUSTAR database), four time periods (≤2006, 2007-2011, 2012-2016, ≥2017), logistic regression
- Multicentre registry (EUSTAR database)
- Four time periods (≤2006, 2007-2011, 2012-2016, ≥2017)
- Logistic regression
Main finding
As reported in the abstract
IST use at first evaluation
P < 0.001
Observational data: associations, not effects.
Further findings
Factors associated with therapy initiation (≥2017 cohort, logistic regression)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Shorter disease duration | 0.991 (0.987–0.996) | P < 0.001 | |
| Myositis | 9.9 (1.94–51.76) | P = 0.006 | |
| 0.050.21520Odds ratio (log scale) |
Factors associated with switching (≥2017 cohort)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Higher mRSS | 1.03 (1.00–1.06) | P = 0.035 | |
| Arthritis | 3.03 (1.55–5.94) | P = 0.001 | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | 2007-2011 | ≥2017 | P value |
|---|---|---|---|
| ILD progression rate · 12 ± 3 months≥2017 vs 2007-2011 · declined | 21.3% | 12.1% | P < 0.001 |
MMF as most prescribed IST
- MMF use rose from 7% to 57% (P < 0.001)
Combination therapy
- Rose from 17.9% to 26.9% (P < 0.001)
Factors associated with combination therapy (≥2017 cohort)
- Associated with younger age, higher dyspnea class and arthritis
Original publication
Impact of Evolving Treatment Patterns on Interstitial Lung Disease Progression in Systemic Sclerosis Using the European Scleroderma Trials and Research Database. Arthritis Rheumatol. Published 29 March 2026. doi:10.
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