Older age onset of systemic sclerosis - accelerated disease progression in all disease subsets.

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  • Additional Information
    • Corporate Authors:
      Registry of the German Network for Systemic Scleroderma
    • Source:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 100883501 Publication Model: Print Cited Medium: Internet ISSN: 1462-0332 (Electronic) Linking ISSN: 14620324 NLM ISO Abbreviation: Rheumatology (Oxford) Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford, UK : Avenel, N.J. : Oxford University Press ; Distributed by Mercury International, c1999-
    • Subject Terms:
      Scleroderma, Systemic/*etiology; Adrenal Cortex Hormones/therapeutic use ; Adult ; Age of Onset ; Disease Progression ; Female ; Fingers ; Germany/epidemiology ; Humans ; Hypertension, Pulmonary/etiology ; Immunosuppressive Agents/therapeutic use ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Phenotype ; Scleroderma, Systemic/drug therapy ; Scleroderma, Systemic/epidemiology ; Skin Ulcer/etiology ; Symptom Assessment
    • Abstract:
      Objectives: Systemic sclerosis is a heterogeneous, multisystem disease. It can occur at any age, but most patients develop the disease between the age of 40 to 50 years. There is controversial evidence on whether/how the age at disease onset affects their clinical phenotype. We here investigate the relationship between age at disease onset and symptoms in a large cohort of SSc patients (lcSSc, dcSSc and SSc-overlap syndromes).
      Methods: Clinical data of the registry of the German Network for Systemic Scleroderma including 3281 patients were evaluated and subdivided into three age groups at disease onset (<40 years, 40-60 years, >60 years).
      Results: Among all SSc patients, 24.5% developed their first non-Raynaud phenomenon symptoms at the age <40 years, and 22.5% were older than 60 years of age. In particular, older patients at onset developed the lcSSc subset significantly more often. Furthermore, they had pulmonary hypertension more often, but digital ulcerations less often. Remarkably, the course of the disease was more rapidly progressing in the older cohort (>60 years), except for gastrointestinal and musculoskeletal involvement. No significant difference was found for the use of corticosteroids. However, significantly, fewer patients older than 60 years received immunosuppressive treatment.
      Conclusion: In this large registry, ∼25% of patients developed SSc at an age above 60 years with an increased frequency of lcSSc. In this age group, an onset of internal organ involvement was significantly accelerated across all three subsets. These findings suggest that, in the elderly cohort, more frequent follow-up examinations are required for an earlier detection of organ complications.
      (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology.)
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    • Contributed Indexing:
      Keywords: German Network for Systemic Scleroderma; SSc; age at disease onset; older age; scleroderma; systemic sclerosis
    • Accession Number:
      0 (Adrenal Cortex Hormones)
      0 (Immunosuppressive Agents)
    • Publication Date:
      Date Created: 20200426 Date Completed: 20210122 Latest Revision: 20210122
    • Publication Date:
      20231215
    • Accession Number:
      PMC7590407
    • Accession Number:
      10.1093/rheumatology/keaa127
    • Accession Number:
      32333004