Clinically relevant differences between primary Raynaud's phenomenon and secondary to connective tissue disease

IF 4.6 2区 医学 Q1 RHEUMATOLOGY
Stefano Di Donato , Suiyuan Huang , John D Pauling , Francesco Del Galdo , Maya Sabbagh , Dinesh Khanna , Michael Hughes
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引用次数: 0

Abstract

Objectives

Raynaud's phenomenon (RP) is a symptom complex associated with digital vascular compromise. Our aim was to examine for clinically relevant differences between primary RP (PRP) and secondary RP (SRP) to connective tissue disease.

Methods

We report cross-sectional results from the Patient Survey of experiences of Raynaud's Phenomenon (PASRAP), which aimed to explore the broad-ranging impact of RP. The survey was widely distributed online including via social medial. Participation was voluntary and responses were anonymous.

Results

1229 respondents completed PASRAP with self-reported RP: PRP 218 (17.7 %) and SRP 1011 (82.3 %) of which 903 (92.9 %) Systemic Sclerosis. The mean (SD) age was significantly lower in respondents with PRP (41.7 [11.8] vs 54.2 [12.4] years, P<0.0001). During attacks, more subjects with SRP reported cyanotic colour changes (92.2 % vs 86.5 %, P=0.0089). Patients with PRP experienced more pain (72.1 % vs 55.9 %, P<0.0001), numbness (80.3 % vs 69.4 %, P=0.0016), stinging/throbbing (93.4 % vs 80.8 %, P<0.0001), and tingling (84.0 % vs 77.5 %, P=0.0345). Only half of respondents’ symptoms were adequately controlled by their current medication(s), more commonly in SRP (55.2 % vs 45.2 %, P=0.0084). There were important differences in the triggers, number, and seasonal variation of RP attacks.

Conclusion

There are clinically relevant differences between PRP and SRP concerning the multifaceted lived patient experience of RP. Neurosensory symptoms are more common in PRP. Patients with SRP are older and present with more colour changes, overrepresented by cyanosis, and with less complete resolution of symptoms between attacks. These data provide novel insights for future RP clinical trial design.

原发性雷诺现象与继发于结缔组织病之间的临床相关差异
目的雷诺现象(Raynaud's phenomenon,RP)是一种与数字血管损害相关的症状综合。我们的目的是研究原发性雷诺现象(PRP)和继发性雷诺现象(SRP)与结缔组织疾病之间的临床相关性差异。方法我们报告了雷诺现象患者经历调查(PASRAP)的横断面结果,该调查旨在探索雷诺现象的广泛影响。该调查通过社交媒体等方式在网上广泛传播。结果有 1229 名受访者完成了 PASRAP,他们自述患有雷诺现象:PRP 218 人(17.7%),SRP 1011 人(82.3%),其中 903 人(92.9%)患有系统性硬化症。PRP受访者的平均(标清)年龄明显较低(41.7 [11.8] 岁 vs 54.2 [12.4]岁,P<0.0001)。在发作期间,更多的 SRP 患者报告了发绀的颜色变化(92.2% vs 86.5%,P=0.0089)。PRP 患者经历更多的疼痛(72.1 % vs 55.9 %,P<0.0001)、麻木(80.3 % vs 69.4 %,P=0.0016)、刺痛/刺痒(93.4 % vs 80.8 %,P<0.0001)和刺痛(84.0 % vs 77.5 %,P=0.0345)。只有半数受访者的症状得到了现有药物的充分控制,这在 SRP 中更为常见(55.2% vs 45.2%,P=0.0084)。在 RP 发作的诱因、次数和季节性变化方面存在重要差异。神经感觉症状在 PRP 中更为常见。SRP 患者年龄较大,表现出更多的颜色变化,其中以紫绀居多,而且在两次发作之间症状的缓解程度较差。这些数据为未来的 RP 临床试验设计提供了新的见解。
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来源期刊
CiteScore
9.20
自引率
4.00%
发文量
176
审稿时长
46 days
期刊介绍: Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.
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