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Classification, categorization and essential items for digital ulcer evaluation in systemic sclerosis: a DeSScipher/European Scleroderma Trials and Research group (EUSTAR) survey
- Source :
- Arthritis Research & Therapy, Arthritis Research & Therapy, Vol 21, Iss 1, Pp 1-6 (2019)
- Publication Year :
- 2018
-
Abstract
- Background: A consensus on digital ulcer (DU) definition in systemic sclerosis (SSc) has been recently reached (Suliman et al., J Scleroderma Relat Disord 2:115-20, 2017), while for their evaluation, classification and categorisation, it is still missing. The aims of this study were to identify a set of essential items for digital ulcer (DU) evaluation, to assess if the existing DU classification was useful and feasible in clinical practice and to investigate if the new categorisation was preferred to the simple distinction of DU in recurrent and not recurrent, in patients with systemic sclerosis (SSc).Methods: DeSScipher is the largest European multicentre study on SSc. It consists of five observational trials (OTs), and one of them, OT1, is focused on DU management. The DeSScipher OT1 items on DU that reached ≥ 60% of completion rate were administered to EUSTAR (European Scleroderma Trials and Research group) centres via online survey. Questions about feasibility and usefulness of the existing DU classification (DU due to digital pitting scars, to loss of tissue, derived from calcinosis and gangrene) and newly proposed categorisation (episodic, recurrent and chronic) were also asked.Results: A total of 84/148 (56.8%) EUSTAR centres completed the questionnaire. DeSScipher items scored by ≥ 70% of the participants as essential and feasible for DU evaluation were the number of DU defined as a loss of tissue (level of agreement 92%), recurrent DU (84%) and number of new DU (74%). For 65% of the centres, the proposed classification of DU was considered useful and feasible in clinical practice. Moreover, 80% of the centres preferred the categorisation of DU in episodic, recurrent and chronic to simple distinction in recurrent/not recurrent DU.Conclusions: For clinical practice, EUSTAR centres identified only three essential items for DU evaluation and considered the proposed classification and categorisation as useful and feasible. The set of items needs to be validated while further implementation of DU classification and categorisation is warranted.Trial registration: Observational trial on DU (OT1) is one of the five trials of the DeSScipher project (ClinicalTrials.gov; OT1 Identifier: NCT01836263, posted on April 19, 2013).
- Subjects :
- 0301 basic medicine
Male
lcsh:Diseases of the musculoskeletal system
Observational Trial
2745 Rheumatology
Digital ulcer
Categorisation
Scleroderma
Systemic sclerosi
0302 clinical medicine
Surveys and Questionnaires
Immunology and Allergy
Prospective Studies
10051 Rheumatology Clinic and Institute of Physical Medicine
Digital ulcers
Middle Aged
Calcium Channel Blockers
Classification
3. Good health
Clinical Practice
Categorization
2723 Immunology and Allergy
Systemic sclerosis
Drug Therapy, Combination
Female
Research Article
Adult
medicine.medical_specialty
Immunology
610 Medicine & health
Sildenafil Citrate
Fingers
03 medical and health sciences
Rheumatology
Skin Ulcer
medicine
Humans
In patient
European Union
Iloprost
030203 arthritis & rheumatology
2403 Immunology
Scleroderma, Systemic
business.industry
Bosentan
Essential item
medicine.disease
030104 developmental biology
Essential items
Physical therapy
Observational study
lcsh:RC925-935
business
Subjects
Details
- ISSN :
- 14786362 and 14786354
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Arthritis researchtherapy
- Accession number :
- edsair.doi.dedup.....d3150b966943a925f3af238232752434