American College of Rheumatology Annual Meeting

American College of Rheumatology Annual Meeting

Source:

Garaiman A. Abstract #1383. Presented at: ACR Convergence 2021; November 5-9, 2021 (virtual meeting).

Disclosures: Garaiman reports no relevant financial disclosures. Please see the abstract for all other authors’ relevant financial disclosures.
November 08, 2021
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Platelet inhibitors linked to lower risk for digital ulcers in systemic sclerosis

Source:

Garaiman A. Abstract #1383. Presented at: ACR Convergence 2021; November 5-9, 2021 (virtual meeting).

Disclosures: Garaiman reports no relevant financial disclosures. Please see the abstract for all other authors’ relevant financial disclosures.
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A prediction model presented at ACR Convergence 2021 demonstrated that the use of platelet inhibitors could predict a lower probability of digital ulcer occurrence among patients with systemic sclerosis.

“We all know that digital ulcers are common in patients with systemic sclerosis; up to 50% of the patients may develop these lesions, and if we leave these lesions untreated, they may turn gangrenous and the patients may require amputation,” Alexandru Garaiman, a doctoral student in clinical science at the department of rheumatology at the University Hospital Zurich in Switzerland said during a press conference. “Although, the use of iloprost, PDE5 inhibitors or bosentan is beneficial in the management of digital ulcers, the prevention and healing of digital ulcers is still a challenge in clinical practice.”

“Our model revealed that platelet inhibitors are associated with a lower probability of digital ulcer occurrence,” Alexandru Garaiman, told attendees. Source: Adobe Stock

Garaiman and colleagues used prospective data from the European Scleroderma Trials and Research group (EUSTAR) registry to identify patients who met the 2013 ACR/EULAR SSc classification criteria with comprehensive longitudinal data on the presence of digital ulcers and platelet inhibitors.

The dataset — which included information from each patient’s (n = 3,710) last follow-up visit — was split into two cohorts: patients recorded in the EUSTAR registry before Jan. 1, 2017 (derivation cohort), and those recorded after (validation cohort).

More than half of the patients (67.8%) had limited cutaneous systemic sclerosis, 14.6% were male, median disease duration was 8.94 years and median age was 56.97 years.

At baseline, 486 patients had digital ulcers and 150 had taken platelet inhibitors. Median follow-up was 1.03 years, at which time 487 patients had digital ulcers and 90 had taken platelet inhibitors.

According to the researchers, their model confirmed previously reported risk factors for the presence of digital ulcers at follow-up, including smoking, prior digital ulcers and SCL-70 positive status, among others.

Additionally, their model revealed that exposure to platelet therapy was associated with a lower odds ratio of digital ulcer occurrence at follow-up (OR = .25; 95% CI, .07-.77).

“We developed and validated a performance prediction model, which is ready to assist the rheumatologist in decision making regarding the management of digital ulcers,” Garaiman said. “... Our model revealed that platelet inhibitors are associated with a lower probability of digital ulcer occurrence. But, of course, all these findings should be confirmed, ideally in a randomized, clinical, controlled trial before treatment recommendations or guidelines can be made.”

He added that “if the therapeutic effect of platelet inhibitors can be also demonstrated in this study design, this would mean we’d have another treatment option for systemic sclerosis patients with digital ulcers, and one that is readily available in most countries at a low price.”