TY - JOUR
T1 - A composite serum biomarker index for the diagnosis of systemic sclerosis-associated interstitial lung disease : a multicenter, observational cohort study
AU - Jee, A. S.
AU - Stewart, I.
AU - Youssef, P.
AU - Adelstein, S.
AU - Lai, Donna
AU - Hua, S.
AU - Stevens, W.
AU - Proudman, S.
AU - Ngian, G.-S.
AU - Glaspole, I. N.
AU - Moodley, Y. P.
AU - Bleasel, J. F.
AU - Macansh, S.
AU - Nikpour, M.
AU - Sahhar, J.
AU - Corte, T. J.
AU - Cooley, H. M.
AU - Hansen, D.
AU - Hill, C.
AU - Major, G. A. C.
AU - Moghaddami, M.
AU - Nash, P.
AU - Roddy, J.
AU - Tymms, K.
AU - Walker, J. G.
AU - Cooper, W. A.
AU - Ellis, S. J.
AU - Goh, N. S. L.
AU - Grainge, C.
AU - Hopkins, P.
AU - Keir, G. J.
AU - Mahar, A.
AU - Reynolds, P. N.
AU - Tan, D.
AU - Zappala, C. J.
AU - Nguyen, M.
AU - Australian Scleroderma Cohort Study, null
AU - Australian Scleroderma Interest Group, null
AU - Australian Idiopathic Pulmonary Fibrosis Registry, null
N1 - Publisher Copyright:
© 2023 The Authors. Arthritis & Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.
PY - 2023/8
Y1 - 2023/8
N2 - Objective: In patients with systemic sclerosis (SSc), we investigated composite serum biomarker panels for the diagnosis and risk stratification of SSc–associated interstitial lung disease (SSc-ILD). Methods: We analyzed 28 biomarkers in 640 participants: 259 patients with SSc-ILD and 179 SSc patients without ILD (Australian Scleroderma Cohort Study), 172 patients with idiopathic pulmonary fibrosis (IPF-controls) (Australian IPF Registry), and 30 healthy controls. A composite index was developed from biomarkers associated with ILD in multivariable analysis derived at empirical thresholds. We evaluated the performance of the index to identify ILD, and specifically SSc-ILD, and its association with lung function, disease extent on radiography, and patient health–related quality of life in derivation and validation cohorts. Biomarkers to distinguish SSc-ILD from IPF-controls were identified. Results: A composite biomarker index, comprising surfactant protein D (SP-D), Ca15-3, and intercellular adhesion molecule 1 (ICAM-1), was strongly associated with SSc-ILD diagnosis, independent of age, sex, smoking history, and lung function (for biomarker index score 3, pooled adjusted odds ratio was 12.72 (95% confidence interval 4.59–35.21) (P < 0.001). The composite index strengthened the performance of individual biomarkers for SSc-ILD identification. In SSc patients, a higher index was associated with worse baseline disease severity (for biomarker index score 3 relative to biomarker index score 0, the adjusted absolute change in forced vital capacity percent predicted was −17.84% and the diffusing capacity for carbon monoxide percent predicted was −20.16%; both P < 0.001). Conclusion: A composite serum biomarker index, comprising SP-D, Ca15-3, and ICAM-1, may improve the identification and risk stratification of ILD in SSc patients at baseline.
AB - Objective: In patients with systemic sclerosis (SSc), we investigated composite serum biomarker panels for the diagnosis and risk stratification of SSc–associated interstitial lung disease (SSc-ILD). Methods: We analyzed 28 biomarkers in 640 participants: 259 patients with SSc-ILD and 179 SSc patients without ILD (Australian Scleroderma Cohort Study), 172 patients with idiopathic pulmonary fibrosis (IPF-controls) (Australian IPF Registry), and 30 healthy controls. A composite index was developed from biomarkers associated with ILD in multivariable analysis derived at empirical thresholds. We evaluated the performance of the index to identify ILD, and specifically SSc-ILD, and its association with lung function, disease extent on radiography, and patient health–related quality of life in derivation and validation cohorts. Biomarkers to distinguish SSc-ILD from IPF-controls were identified. Results: A composite biomarker index, comprising surfactant protein D (SP-D), Ca15-3, and intercellular adhesion molecule 1 (ICAM-1), was strongly associated with SSc-ILD diagnosis, independent of age, sex, smoking history, and lung function (for biomarker index score 3, pooled adjusted odds ratio was 12.72 (95% confidence interval 4.59–35.21) (P < 0.001). The composite index strengthened the performance of individual biomarkers for SSc-ILD identification. In SSc patients, a higher index was associated with worse baseline disease severity (for biomarker index score 3 relative to biomarker index score 0, the adjusted absolute change in forced vital capacity percent predicted was −17.84% and the diffusing capacity for carbon monoxide percent predicted was −20.16%; both P < 0.001). Conclusion: A composite serum biomarker index, comprising SP-D, Ca15-3, and ICAM-1, may improve the identification and risk stratification of ILD in SSc patients at baseline.
UR - https://hdl.handle.net/1959.7/uws:73773
U2 - 10.1002/art.42491
DO - 10.1002/art.42491
M3 - Article
SN - 2326-5191
VL - 75
SP - 1424
EP - 1433
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
IS - 8
ER -
