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

Moinzadeh P, Kuhr K, Siegert E, Mueller-Ladner U, Riemekasten G, Günther C, Kötter I, Henes J, Blank N, Zeidler G, Pfeiffer C, Juche A, Jandova I, Ehrchen J, Schmalzing M, Susok L, Schmeiser T, Sunderkoetter C, Distler J, Worm M, Kreuter A, Krieg T, Hunzelmann N (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Book Volume: 59

Pages Range: 3380-3389

Journal Issue: 11

DOI: 10.1093/rheumatology/keaa127

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.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Köln Germany (DE) Universität zu Köln Germany (DE) Berliner Institut für Gesundheitsforschung (BIH) Germany (DE) Justus-Liebig-Universität Gießen Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Asklepios Klinik Altona Germany (DE) Universitätsklinikum Tübingen Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Universitätsklinikum Ulm Germany (DE) Immanuel Krankenhaus Berlin Germany (DE) Universitätsklinikum Freiburg Germany (DE) Universitätsklinikum Münster Germany (DE) Universitätsklinikum Würzburg Germany (DE) Ruhr-Universität Bochum (RUB) Germany (DE) Krankenhaus St. Josef Germany (DE) Universitätsklinikum Halle (Saale) Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) HELIOS Kliniken Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE)

How to cite

APA:

Moinzadeh, P., Kuhr, K., Siegert, E., Mueller-Ladner, U., Riemekasten, G., Günther, C.,... Hunzelmann, N. (2020). Older age onset of systemic sclerosis - accelerated disease progression in all disease subsets. Rheumatology, 59(11), 3380-3389. https://doi.org/10.1093/rheumatology/keaa127

MLA:

Moinzadeh, Pia, et al. "Older age onset of systemic sclerosis - accelerated disease progression in all disease subsets." Rheumatology 59.11 (2020): 3380-3389.

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