Di Donato, S. orcid.org/0000-0003-1256-0761, Pauling, J.D., Ramjug, S. et al. (149 more authors) (2025) Temporal trends in vascular medication use in 8079 patients with systemic sclerosis: insights to inform future trials and therapeutic strategies from the EUSTAR cohort. Rheumatology. keaf290. ISSN: 1462-0324
Abstract
Objectives Systemic sclerosis (SSc) is characterized by widespread vascular damage resulting in digital and systemic vasculopathic sequelae. Although there are effective treatments available, vascular disease remains a significant cause of morbidity and mortality in SSc. Our aim was to describe patterns of vascular medication use in SSc, including examination for potential changes over time.
Methods A cross-sectional study of SSc patients enrolled in the EUSTAR database meeting 2013 ACR/EULAR SSc criteria. Patients were divided into two time periods: 2012–2017 and 2018–2022. We analysed the prescription patterns of endothelin receptor antagonists (ERA), phosphodiesterase type-5 inhibitors (PDE5i), calcium channel blockers (CCB), intravenous iloprost, and antiplatelet therapies. Logistic regression was used to evaluate temporal trends and interaction effects.
Results A total of 8079 patients were included. Significant increases over time were observed in the use of ERA (7% to 12%, P < 0.001), PDE5i (5.4% to 7.2%, P = 0.064), CCB (20% to 32%, P < 0.001) and anti-platelet therapies (15% to 20%, P < 0.001). There was a notable decrease in iloprost use (3.1% to 0.3%, P < 0.001). The prevalence of active digital ulcers (DU) decreased (16% to 13%, P = 0.040), while a history of DU (24% to 30%, P < 0.001) increased. Year-by-year and non-linear increases were noted for ERA and CCB whereas non-linear increase was observed for PDE5i. Year-by-year and non-linear decrease was observed for Iloprost prescription.
Conclusion A significant change has occurred over time in vascular medication use in SSc patients, with increased utilization of ERA, PDE5i, CCB and anti-platelet therapies suggesting the adoption of more proactive and/or preventive treatment strategies.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This is an author produced version of an article published in Rheumatology, made available under the terms of the Creative Commons Attribution License (CC-BY), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: | systemic sclerosis, scleroderma, vascular, medication, prescription, temporal |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 24 Jul 2025 15:21 |
Last Modified: | 24 Jul 2025 15:21 |
Status: | Published online |
Publisher: | Oxford University Press (OUP) |
Identification Number: | 10.1093/rheumatology/keaf290 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:229582 |
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