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Risk of Digital Vascular Events in Scleroderma Patients Who Have Both Anticentromere and Anti–Interferon‐Inducible Protein 16 Antibodies
Author(s) -
McMahan Zsuzsanna H.,
Wigley Frederick M.,
CasciolaRosen Livia
Publication year - 2017
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22978
Subject(s) - scleroderma (fungus) , medicine , antibody , odds ratio , gangrene , confidence interval , gastroenterology , immunology , pathology , inoculation
Objective To evaluate whether scleroderma patients who are double‐positive for anti–interferon‐inducible protein 16 (anti–IFI‐16) antibodies and anticentromere (anti‐CENP) antibodies are at increased risk for significant digital vascular events relative to patients positive for anti‐CENP antibodies alone. Methods Sera from 165 scleroderma patients who tested positive for anti‐CENP antibodies upon clinical evaluation were reassayed for both anti‐CENP and anti–IFI‐16 antibodies using enzyme‐linked immunosorbent assay testing. Patients who were positive for anti‐CENP antibodies alone were then compared to patients who were double‐positive for both anti–IFI‐16 and anti‐CENP antibodies. The association between a history of significant digital vascular events (digital pits, ischemic digital ulcers, and/or gangrene) and double‐positive antibody status was examined using chi‐square tests. After completion of univariate analysis, multivariable analyses were done to adjust for clinically relevant covariates. Results Of the 165 anti–CENP antibody positive patients, 21 (12.7%) also had anti–IFI‐16 antibodies. Patients who were double‐positive for anti‐CENP and anti‐IFI‐16 antibodies were more likely to have had digital pits, ischemic digital ulcers, and/or gangrene ( P = 0.03). After adjustment for clinically relevant covariates (age, cutaneous subtype, disease duration, and smoking), double‐positive patients remained at significantly higher odds of having severe Raynaud's phenomenon (odds ratio 3.5 [95% confidence interval 1.1–11.1]; P = 0.03). Conclusion Scleroderma patients who are double‐positive for antibodies recognizing CENP and IFI‐16 are significantly more likely to have significant digital vascular events during the course of their disease. This study provides further evidence that anti‐CENP and anti–IFI‐16 antibodies are disease biomarkers that may be used for risk stratification of vascular events in scleroderma.