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*Only for medical professionals to read the latest data from the Asian population! At the 2021 Asia-Pacific Association of Rheumatology Associations (APLAR) Annual Meeting held in Kyoto, Japan, Dr.
Sue-Ann Ng from Singapore General Hospital shared the latest progress on systemic sclerosis (SSc)
.
What is SSc overlap syndrome? According to Dr.
Sue-Ann Ng, the data in this lecture is taken from the SSc/Myositis APLAR Special Interest Group (SIG), which has 36 members from 19 countries
.
The SSc-related research projects carried out by SIG include the establishment of an Asian SSc database and an Asian cross-section based on the International SSc Initiation Cohort Study (INSYNC) variables, as well as the clinical features and outcomes of patients with SSc overlap syndrome in a longitudinal cohort study
.
SSc overlap syndrome is a group of heterogeneous diseases of SSc, and 20%~30% of SSc patients meet the definition of overlap syndrome
.
The course, clinical phenotype, organ involvement and prognosis of SSc patients and overlap syndrome patients are different
.
Compared with diffuse SSc (DcSSc), overlap syndrome is more common in localized SSc (LcSSc)
.
The most common comorbid connective tissue diseases (CTD) include Sjogren’s syndrome (SS), rheumatoid arthritis (RA), myositis, and systemic lupus erythematosus (SLE)
.
What is the difference between overlap syndrome and SSc? SSc patients are prone to be positive for SSc specific antibodies, such as anti-centromere, anti-Sci-70, and anti-RNA polymerase III
.
Patients with overlap syndrome are also commonly positive for other antibodies, such as anti-Ro, anti-La, anti-Jo-1, anti-cyclic citrullinated peptide antibody (anti-CCP), anti PM/SCL, anti-Sm and anti-dsDNA and so on
.
Patients with SSc are also more likely to have finger ulcers and skin involvement
.
For patients with overlap syndrome, arthritis, musculoskeletal, and gastrointestinal tract are easily complicated
.
Pulmonary fibrosis and cardiac involvement are similar in the two types of patients
.
In terms of treatment and outcome, more patients with SSc overlap syndrome will receive immunosuppressive therapy, and the survival rate is not always related to disease classification
.
Compared with disease types, SSc-specific antibodies are more reliable survival predictors.
For example, anti-centromere and anti-RNP predict better survival rates than anti-Sci-70 or anti-RNA polymerase III
.
What are the new discoveries in this research? The study is a cross-sectional study.
The purpose is to compare the clinical characteristics and survival outcomes of SSc patients and SSc overlap syndrome patients in the Asian cohort study, and propose the hypothesis that the two groups of patients have different disease courses, serum antibody profiles, organ involvement, and prognosis
.
Participating countries and regions include Singapore, Malaysia, Hong Kong and Thailand
.
The SSc patients selected in the study meet the 2013 American College of Rheumatology/European Alliance Against Rheumatism (ACR/EULAR) SSc classification definition; SSc overlap syndrome patients meet the CTD disease criteria
.
The researchers analyzed the subjects' baseline characteristics and survival outcomes, and the review date was January 31, 2020
.
Of the 520 patients enrolled in the study, 72% (373) were SSc patients, and 28% (147) were SSc overlap syndrome patients
.
Among patients with SSc overlap syndrome, 26% have RA, 31% have myositis, and 43% have SLE
.
The epidemiological and clinical characteristics of the subjects are shown in Figure 1.
It can be seen that patients with SSc overlap syndrome have a higher proportion of Raynaud’s phenomenon The skin suddenly becomes pale, and then the skin becomes purple and red, accompanied by transient symptoms such as local chills, paresthesias, and pain) and joint muscle involvement
.
Figure 1 Epidemiological and clinical characteristics In addition, the antibody characteristics of the two groups are also very different, and patients with overlap syndrome have a higher proportion of immunomodulator use (Figure 2)
.
Figure 2 The antibody characteristics of the two groups of people summarize the results of the study, including the following four points: Compared with patients with SSc overlap syndrome, the modified Ronan skin score (MRSC) of SSc patients was significantly higher (11.
5±10.
7 vs.
8.
2±) 10.
7, p=0.
0131); SSc overlap syndrome patients have a higher proportion of Raynaud’s phenomenon and joint muscle involvement; SSc patients and SSc overlap syndrome patients also show differences in antibody profiles; SSc overlap syndrome patients are more likely Received immunomodulator therapy (87.
0% vs.
71.
3, p<0.
001)
.
In the next step, the team will study the involvement of other organs in patients with SSc/SSc overlap syndrome and survival analysis
.
Sue-Ann Ng from Singapore General Hospital shared the latest progress on systemic sclerosis (SSc)
.
What is SSc overlap syndrome? According to Dr.
Sue-Ann Ng, the data in this lecture is taken from the SSc/Myositis APLAR Special Interest Group (SIG), which has 36 members from 19 countries
.
The SSc-related research projects carried out by SIG include the establishment of an Asian SSc database and an Asian cross-section based on the International SSc Initiation Cohort Study (INSYNC) variables, as well as the clinical features and outcomes of patients with SSc overlap syndrome in a longitudinal cohort study
.
SSc overlap syndrome is a group of heterogeneous diseases of SSc, and 20%~30% of SSc patients meet the definition of overlap syndrome
.
The course, clinical phenotype, organ involvement and prognosis of SSc patients and overlap syndrome patients are different
.
Compared with diffuse SSc (DcSSc), overlap syndrome is more common in localized SSc (LcSSc)
.
The most common comorbid connective tissue diseases (CTD) include Sjogren’s syndrome (SS), rheumatoid arthritis (RA), myositis, and systemic lupus erythematosus (SLE)
.
What is the difference between overlap syndrome and SSc? SSc patients are prone to be positive for SSc specific antibodies, such as anti-centromere, anti-Sci-70, and anti-RNA polymerase III
.
Patients with overlap syndrome are also commonly positive for other antibodies, such as anti-Ro, anti-La, anti-Jo-1, anti-cyclic citrullinated peptide antibody (anti-CCP), anti PM/SCL, anti-Sm and anti-dsDNA and so on
.
Patients with SSc are also more likely to have finger ulcers and skin involvement
.
For patients with overlap syndrome, arthritis, musculoskeletal, and gastrointestinal tract are easily complicated
.
Pulmonary fibrosis and cardiac involvement are similar in the two types of patients
.
In terms of treatment and outcome, more patients with SSc overlap syndrome will receive immunosuppressive therapy, and the survival rate is not always related to disease classification
.
Compared with disease types, SSc-specific antibodies are more reliable survival predictors.
For example, anti-centromere and anti-RNP predict better survival rates than anti-Sci-70 or anti-RNA polymerase III
.
What are the new discoveries in this research? The study is a cross-sectional study.
The purpose is to compare the clinical characteristics and survival outcomes of SSc patients and SSc overlap syndrome patients in the Asian cohort study, and propose the hypothesis that the two groups of patients have different disease courses, serum antibody profiles, organ involvement, and prognosis
.
Participating countries and regions include Singapore, Malaysia, Hong Kong and Thailand
.
The SSc patients selected in the study meet the 2013 American College of Rheumatology/European Alliance Against Rheumatism (ACR/EULAR) SSc classification definition; SSc overlap syndrome patients meet the CTD disease criteria
.
The researchers analyzed the subjects' baseline characteristics and survival outcomes, and the review date was January 31, 2020
.
Of the 520 patients enrolled in the study, 72% (373) were SSc patients, and 28% (147) were SSc overlap syndrome patients
.
Among patients with SSc overlap syndrome, 26% have RA, 31% have myositis, and 43% have SLE
.
The epidemiological and clinical characteristics of the subjects are shown in Figure 1.
It can be seen that patients with SSc overlap syndrome have a higher proportion of Raynaud’s phenomenon The skin suddenly becomes pale, and then the skin becomes purple and red, accompanied by transient symptoms such as local chills, paresthesias, and pain) and joint muscle involvement
.
Figure 1 Epidemiological and clinical characteristics In addition, the antibody characteristics of the two groups are also very different, and patients with overlap syndrome have a higher proportion of immunomodulator use (Figure 2)
.
Figure 2 The antibody characteristics of the two groups of people summarize the results of the study, including the following four points: Compared with patients with SSc overlap syndrome, the modified Ronan skin score (MRSC) of SSc patients was significantly higher (11.
5±10.
7 vs.
8.
2±) 10.
7, p=0.
0131); SSc overlap syndrome patients have a higher proportion of Raynaud’s phenomenon and joint muscle involvement; SSc patients and SSc overlap syndrome patients also show differences in antibody profiles; SSc overlap syndrome patients are more likely Received immunomodulator therapy (87.
0% vs.
71.
3, p<0.
001)
.
In the next step, the team will study the involvement of other organs in patients with SSc/SSc overlap syndrome and survival analysis
.
