Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis?
Objectives While important progress was made regarding the treatment of systemic sclerosis (SSc), there is still no evidence-based disease-modifying treatment available for SSc-related gastrointestinal (GI) manifestations. We aimed to identify an association between immunosuppressive therapy and the...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-07-01
|
| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/10/3/e004333.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1825208804880416768 |
|---|---|
| author | Oliver Distler Cosimo Bruni Suzana Jordan Carina Mihai Muriel Elhai Rucsandra Dobrota Alexandru Garaiman Mike Oliver Becker Lea Stamm Sherif Ismail Norina Zampatti Aurora Maria Tatu |
| author_facet | Oliver Distler Cosimo Bruni Suzana Jordan Carina Mihai Muriel Elhai Rucsandra Dobrota Alexandru Garaiman Mike Oliver Becker Lea Stamm Sherif Ismail Norina Zampatti Aurora Maria Tatu |
| author_sort | Oliver Distler |
| collection | DOAJ |
| description | Objectives While important progress was made regarding the treatment of systemic sclerosis (SSc), there is still no evidence-based disease-modifying treatment available for SSc-related gastrointestinal (GI) manifestations. We aimed to identify an association between immunosuppressive therapy and the the severity of GI symptoms, measured by the University of California at Los Angeles/Scleroderma Clinical Trial Consortium Gastro-Intestinal Tract instrument 2.0 (GIT).Methods We selected patients with SSc who had at least two visits (further referred to as ‘baseline’ and ‘follow-up’) with completed GITs, within an interval of 12±3 months. The study outcome was the GIT score at follow-up. We used multivariable linear regression with the following covariates: immunosuppressive therapy during observation, immunosuppressive therapy before baseline, baseline GIT and several baseline parameters selected by clinical judgement as potentially influencing GI symptoms.Results We included 209 SSc patients (82.3% female, median age 59.0 years, median disease duration 6.0 years, 40 (19.1%) diffuse cutaneous SSc, median baseline GIT 0.19). Of these, 71 were exposed to immunosuppressive therapy during the observation period, and, compared with unexposed patients, had overall more severe SSc and a higher prevalence of treatment with proton pump inhibitors. In multivariable linear regression, immunosuppressive therapy during the period of observation and lower baseline GIT scores were significantly associated with lower (better) GIT scores at follow-up.Conclusion Immunosuppressive treatment was associated with lower GIT scores in our cohort, which suggests the potential effects of immunosuppressants on GI manifestations in patients with SSc, requiring confirmation in prospective randomised clinical trials. |
| format | Article |
| id | doaj-art-20d3b7b3544a43c487b19d01de27116f |
| institution | Kabale University |
| issn | 2056-5933 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj-art-20d3b7b3544a43c487b19d01de27116f2025-02-06T22:40:13ZengBMJ Publishing GroupRMD Open2056-59332024-07-0110310.1136/rmdopen-2024-004333Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis?Oliver Distler0Cosimo Bruni1Suzana Jordan2Carina Mihai3Muriel Elhai4Rucsandra Dobrota5Alexandru Garaiman6Mike Oliver Becker7Lea Stamm8Sherif Ismail9Norina Zampatti10Aurora Maria Tatu11Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Rheumatology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Rheumatology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Rheumatology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Rheumatology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Rheumatology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Internal Medicine, National Research Center, Cairo, EgyptDepartment of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Gastroenterology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandObjectives While important progress was made regarding the treatment of systemic sclerosis (SSc), there is still no evidence-based disease-modifying treatment available for SSc-related gastrointestinal (GI) manifestations. We aimed to identify an association between immunosuppressive therapy and the the severity of GI symptoms, measured by the University of California at Los Angeles/Scleroderma Clinical Trial Consortium Gastro-Intestinal Tract instrument 2.0 (GIT).Methods We selected patients with SSc who had at least two visits (further referred to as ‘baseline’ and ‘follow-up’) with completed GITs, within an interval of 12±3 months. The study outcome was the GIT score at follow-up. We used multivariable linear regression with the following covariates: immunosuppressive therapy during observation, immunosuppressive therapy before baseline, baseline GIT and several baseline parameters selected by clinical judgement as potentially influencing GI symptoms.Results We included 209 SSc patients (82.3% female, median age 59.0 years, median disease duration 6.0 years, 40 (19.1%) diffuse cutaneous SSc, median baseline GIT 0.19). Of these, 71 were exposed to immunosuppressive therapy during the observation period, and, compared with unexposed patients, had overall more severe SSc and a higher prevalence of treatment with proton pump inhibitors. In multivariable linear regression, immunosuppressive therapy during the period of observation and lower baseline GIT scores were significantly associated with lower (better) GIT scores at follow-up.Conclusion Immunosuppressive treatment was associated with lower GIT scores in our cohort, which suggests the potential effects of immunosuppressants on GI manifestations in patients with SSc, requiring confirmation in prospective randomised clinical trials.https://rmdopen.bmj.com/content/10/3/e004333.full |
| spellingShingle | Oliver Distler Cosimo Bruni Suzana Jordan Carina Mihai Muriel Elhai Rucsandra Dobrota Alexandru Garaiman Mike Oliver Becker Lea Stamm Sherif Ismail Norina Zampatti Aurora Maria Tatu Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis? RMD Open |
| title | Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis? |
| title_full | Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis? |
| title_fullStr | Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis? |
| title_full_unstemmed | Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis? |
| title_short | Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis? |
| title_sort | does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis |
| url | https://rmdopen.bmj.com/content/10/3/e004333.full |
| work_keys_str_mv | AT oliverdistler doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT cosimobruni doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT suzanajordan doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT carinamihai doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT murielelhai doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT rucsandradobrota doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT alexandrugaraiman doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT mikeoliverbecker doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT leastamm doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT sherifismail doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT norinazampatti doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis AT auroramariatatu doestherapywithimmunosuppressivedrugsimprovegastrointestinalsymptomsinpatientswithsystemicsclerosis |