Recent Research Highlights Predictors and Outcomes in Systemic Sclerosis

Recent studies presented at the European Alliance of Associations for Rheumatology (EULAR) 2025 congress have shed new light on early detection and progression of systemic sclerosis (SSc). The Very Early Diagnosis of Systemic Sclerosis (VEDOSS) criteria play a crucial role in identifying red flags such as puffy fingers, abnormal nailfold capillaroscopy, and specific autoantibodies in patients with Raynaud's phenomenon, which can signal the very early stage of the disease. Approximately 70% of these patients, exhibiting at least one red flag, may fulfill the comprehensive classification criteria within five years.

However, fulfillment of classification criteria does not always correlate with significant clinical disease progression. Instead, early manifestations like digital ulcers, skin fibrosis, or interstitial lung disease (ILD) serve as more reliable markers of disease advancement. To better understand this progression, researchers analyzed 442 VEDOSS patients who initially did not meet the 2013 ACR/EULAR criteria or show clinical endpoints at baseline. They tracked the first occurrence of key events—such as digital ulcers, increased skin thickness, pulmonary issues, or new organ involvement—over five years.

Results indicated that over half of the patients experienced at least one these critical events within five years, with the likelihood increasing from 11.1% at 12 months to over 65% at five years. Notably, indicators like skin score increases, lung function decline, and digital ulcers were common early signs of disease progression. This highlights the importance of early diagnosis and intervention, which could potentially reduce the high mortality associated with SSc, often related to heart and lung complications, as well as heightened cancer risk, especially hematological malignancies.

Additional research highlighted the increased incidence of hematological cancers in SSc patients, revealing a 1.6% occurrence rate compared to 0.9% in the general population. The risk was especially pronounced in men and those diagnosed at a younger age (18-49 years). These findings emphasize the need for vigilant monitoring and early management strategies to improve patient outcomes.

Overall, these studies point towards the vital role of early detection tools and targeted interventions in managing systemic sclerosis more effectively, potentially altering its course and improving quality of life for affected individuals.

Source: https://medicalxpress.com/news/2025-06-predictors-outcomes-sclerosis.html