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Clinical differences between Thai systemic sclerosis patients with positive versus negative anti‐topoisomerase I
Author(s) -
Foocharoen Chingching,
Suwannachat Prangsuporn,
Netwijitpan Sittichai,
Mahakkanukrauh Ajanee,
Suwannaroj Siraphop,
Nanagara Ratanavadee
Publication year - 2016
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12492
Subject(s) - medicine , gastroenterology , odds ratio , cohort
Background Anti‐topoisomerase I antibody ( ATA ) carries an increased risk of systemic sclerosis ( SS c) internal organ involvement. There have been no published comparisons of the clinical characteristics of patients positive and negative for ATA in Thailand, where the positive rate for ATA is higher than among Caucasians. Objective To define the clinical differences between SS c, positive versus negative, for ATA . Methods A retrospective cohort study was performed among SS c patients over 18 at Srinagarind Hospital, Khon Kaen University, Thailand, during January 2006–December 2013. SS c‐overlap syndrome was excluded. Results Two hundred and ninety‐four SS c patients were included (female : male 2.5 : 1). The majority (68.6%) were the diffuse cutaneous SS c subset (dc SS c). ATA was positive in 252 patients (85.7%), among whom 71.7% had dc SS c and 28.2% limited cutaneous SS c (lc SS c). Using a multivariate analysis, hand deformity had a significantly positive association with ATA (odds ratio [ OR ] 7.01; 95% CI 1.02–48.69), whereas being anti‐centromere ( ACA ) positive had a negative association ( OR 0.17; 95% CI 0.03–0.92). After doing a subgroup analysis of the SS c subset, the median duration of disease at time of pulmonary fibrosis detection among ATA positive dc SS c was significantly shorter than the ATA negative group (1.05 vs . 6.77 years, P = 0.01). Raynaud's phenomenon ( RP ) at onset was significantly more frequent in lc SS c sufferers who were ATA negative than those who were ATA positive (90.5% vs . 56.9%, P = 0.005). Conclusions A high prevalence of ATA positivity was found among Thai SS c patients and this was associated with a high frequency of hand deformity, ACA negativity, a short duration of pulmonary fibrosis in dc SS c and a lower frequency of RP in lc SS c.