- Title
- A Composite Serum Biomarker Index for the Diagnosis of Systemic Sclerosis–Associated Interstitial Lung Disease: A Multicenter, Observational Cohort Study
- Creator
- Jee, Adelle S.; Stewart, Iain; Moodley, Yuben P.; Bleasel, Jane F.; Macansh, Sacha; Nikpour, Mandana; Sahhar, Joanne; Corte, Tamera J.; Australian Scleroderma Cohort Study, Australian Scleroderma Interest Group, Australian Idiopathic Pulmonary Fibrosis Registry, and associated investigators,; Youssef, Peter; Adelstein, Stephen; Lai, Donna; Hua, Sheng; Stevens, Wendy; Proudman, Susanna; Ngian, Gene-Siew; Glaspole, Ian N.
- Relation
- Arthritis and Rheumatology Vol. 75, Issue 8, p. 1424-1433
- Publisher Link
- http://dx.doi.org/10.1002/art.42491
- Publisher
- John Wiley & Sons
- Resource Type
- journal article
- Date
- 2023
- Description
- 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.
- Subject
- systemic sclerosis (SSc); lung disease; biomarkers; patients; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1481244
- Identifier
- uon:50684
- Identifier
- ISSN:2326-5191
- Rights
- © 2023 The Authors. Arthritis & Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
- Language
- eng
- Full Text
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