Ulnar Artery Occlusion: A Vasculopathy Severity Marker in Scleroderma

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Ulnar artery occlusion may function as a relevant marker of vasculopathy severity in systematic sclerosis.
Ulnar artery occlusion may function as a relevant marker of vasculopathy severity in systematic sclerosis.

Ulnar artery occlusion (UAO) as assessed by Doppler ultrasonography may function as a relevant marker of vasculopathy severity in systematic sclerosis, according to a study published in Arthritis & Rheumatology.  

In this cross-sectional multicenter study of patients with systematic sclerosis (N=204) according to 2013 ACR/EULAR classification criteria, researchers assessed the association of UAO with the clinical features of systematic sclerosis using multivariable and univariable ordinal regression models. UAO severity levels were graded as UAO on both hands, only one UAO, and no UAO.

Out of the 204 patients, 37.3% (n=76) showed UAO, which was bilateral in 24% of patients (n=49). As an ordinal event, UAO was significantly associated with positivity for anti-centromere antibodies, late capillaroscopic pattern, higher tricuspid jet velocity, worse values for diffusing capacity of the lungs for carbon monoxide (DLCO), higher Rodnan skin scores, fingertip ulcers history, and disease duration.

Multivariable analyses showed significant associations between UAO and positivity for anti-centromere antibodies (odds ratio [OR], 2.89 [1.36-6.11]; =.0056), lower DLCO values (OR, 0.85 [0.78-0.94]; =.0015), higher Rodnan skin score (OR, 1.65 [1.06-2.56]; =.025), and fingertip ulcer history (OR, 2.55 [1.24-5.21]; =.011).

In the adjusted multivariable ordinal model, UAO was less frequent in patients taking steroids (OR, 0.24 [0.09-0.62]; =.0034) and in women (OR, 0.35 [0.15-0.83]; =.017).

Study investigators concluded that, "Although there is still a need to standardize and further evaluate the validity of [ultrasonography] macrovascular evaluation of the hand according to the OMERACT filter, promising early results of therapeutic pilot studies involving the presence of UAO in their inclusion strategies may help to better set the place of these macrovascular features of [systematic sclerosis] in the future."

Multiple authors reported receiving fees and grants from pharmaceutical companies. Please see the reference for complete disclosure information. 

Reference

Lescoat A, Yelnik CM, Coiffier G, et al. Ulnar artery occlusion and severity markers of vasculopathy in systemic sclerosis: a multicenter cross-sectional study [published online December 15, 2018]. Arthritis Rheumatol. doi: 10.1002/art.40799

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