Exposure to ACE inhibitors prior to the onset of scleroderma renal crisis-results from the international scleroderma renal crisis survey

Marie Hudson; Murray Baron; Solène Tatibouet; Daniel E. Furst; Dinesh Khanna; Laura Hummers; Eric Hachulla; Thomas Medsger; Virginia Steen; Firas Alkassab; Sindhu Johnson; Oyvind Midtvedt; Gabriella Szucs; Elena Schiopu; Patricia E. Carreira; Chris T. Derk; Oliver Distler; Murat Inanc; Nader Khalidi; Tafazzul H. Mahmud; Maureen D. Mayes; Kevin McKown; Susanna Proudman; Lidia Rudnicka; Stuart Seigel; Jack Stein; Gabriele Valentini; Sule Yavuz; Hector Arbillaga; Beth Hazel; Jan Schulz; Milton Baker; Mike Becker; Jean Cabane; Andrew Chow; Romy Christmann; Philip Clements; Mary Ellen Csuka; Katharina Hanke; Ina Kötter; Soren Jacobsen; Jason Kur; Edward V. Lally; Sophie Ligier; Shikha Mittoo; Christine Peschken; Paloma Garcia De La Pena-Lefebvre; Viviane Queyrel; Richard Silver; Robert Simms; Klaus Sondergaard; Yves Troyanov; Maria C. Turi; John Varga; Panayiotis G. Vlachoyiannopoulos; Alexandre E. Voskuyl; Carol Yeadon; Rene Westhovens

doi:10.1016/j.semarthrit.2013.09.008

Exposure to ACE inhibitors prior to the onset of scleroderma renal crisis-results from the international scleroderma renal crisis survey

Marie Hudson, Murray Baron, Solène Tatibouet, Daniel E. Furst, Dinesh Khanna, Laura Hummers, Eric Hachulla, Thomas Medsger, Virginia Steen, Firas Alkassab, Sindhu Johnson, Oyvind Midtvedt, Gabriella Szucs, Elena Schiopu, Patricia E. Carreira, Chris T. Derk, Oliver Distler, Murat Inanc, Nader Khalidi, Tafazzul H. MahmudMaureen D. Mayes, Kevin McKown, Susanna Proudman, Lidia Rudnicka, Stuart Seigel, Jack Stein, Gabriele Valentini, Sule Yavuz, Hector Arbillaga, Beth Hazel, Jan Schulz, Milton Baker, Mike Becker, Jean Cabane, Andrew Chow, Romy Christmann, Philip Clements, Mary Ellen Csuka, Katharina Hanke, Ina Kötter, Soren Jacobsen, Jason Kur, Edward V. Lally, Sophie Ligier, Shikha Mittoo, Christine Peschken, Paloma Garcia De La Pena-Lefebvre, Viviane Queyrel, Richard Silver, Robert Simms, Klaus Sondergaard, Yves Troyanov, Maria C. Turi, John Varga, Panayiotis G. Vlachoyiannopoulos, Alexandre E. Voskuyl, Carol Yeadon, Rene Westhovens

School of Medicine

Research output: Contribution to journal › Article › peer-review

75 Scopus citations

Abstract

Objective: To determine whether exposure to angiotensin-converting enzyme (ACE) inhibitors prior to the onset of scleroderma renal crisis (SRC) leads to worse outcomes of SRC. Methods: Prospective cohort study of incident SRC subjects. The exposure of interest was ACE inhibitors prior to the onset of SRC. The outcomes of interest were death or dialysis during the first year after the onset of SRC. Results: A total of 87 subjects with incident SRC were identified and 1-year follow-up data were obtained in 75 (86%) subjects. Overall, 27 (36%) subjects died within the first year and an additional 19 (25%) remained on dialysis 1 year after the onset of SRC. In adjusted analyses, exposure to ACE inhibitors prior to the onset of SRC was associated with an increased risk of death (hazard ratio 2.42, 95% CI 1.02, 5.75, p < 0.05 in the primary analysis and 2.17, 95% CI 0.88, 5.33, p = 0.09 after post-hoc adjustment for pre-existing hypertension). Conclusion: Overall, the 1-year outcomes of SRC were poor. Prior exposure to ACE inhibitors was associated with an increased risk of death after the onset of SRC, although there was uncertainty around the magnitude of the risk and the possibility of residual confounding could not be ruled out. Further studies will be needed to confirm these findings.

Original language	English (US)
Pages (from-to)	666-672
Number of pages	7
Journal	Seminars in Arthritis and Rheumatism
Volume	43
Issue number	5
DOIs	https://doi.org/10.1016/j.semarthrit.2013.09.008
State	Published - Apr 2014

Keywords

ACE inhibitors
Scleroderma
Scleroderma renal crisis

ASJC Scopus subject areas

Rheumatology
Anesthesiology and Pain Medicine

Access to Document

10.1016/j.semarthrit.2013.09.008

Cite this

Hudson, M., Baron, M., Tatibouet, S., Furst, D. E., Khanna, D., Hummers, L., Hachulla, E., Medsger, T., Steen, V., Alkassab, F., Johnson, S., Midtvedt, O., Szucs, G., Schiopu, E., Carreira, P. E., Derk, C. T., Distler, O., Inanc, M., Khalidi, N., ... Westhovens, R. (2014). Exposure to ACE inhibitors prior to the onset of scleroderma renal crisis-results from the international scleroderma renal crisis survey. Seminars in Arthritis and Rheumatism, 43(5), 666-672. https://doi.org/10.1016/j.semarthrit.2013.09.008

Hudson, M, Baron, M, Tatibouet, S, Furst, DE, Khanna, D, Hummers, L, Hachulla, E, Medsger, T, Steen, V, Alkassab, F, Johnson, S, Midtvedt, O, Szucs, G, Schiopu, E, Carreira, PE, Derk, CT, Distler, O, Inanc, M, Khalidi, N, Mahmud, TH, Mayes, MD, McKown, K, Proudman, S, Rudnicka, L, Seigel, S, Stein, J, Valentini, G, Yavuz, S, Arbillaga, H, Hazel, B, Schulz, J, Baker, M, Becker, M, Cabane, J, Chow, A, Christmann, R, Clements, P, Csuka, ME, Hanke, K, Kötter, I, Jacobsen, S, Kur, J, Lally, EV, Ligier, S, Mittoo, S, Peschken, C, De La Pena-Lefebvre, PG, Queyrel, V, Silver, R, Simms, R, Sondergaard, K, Troyanov, Y, Turi, MC, Varga, J, Vlachoyiannopoulos, PG, Voskuyl, AE, Yeadon, C & Westhovens, R 2014, 'Exposure to ACE inhibitors prior to the onset of scleroderma renal crisis-results from the international scleroderma renal crisis survey', Seminars in Arthritis and Rheumatism, vol. 43, no. 5, pp. 666-672. https://doi.org/10.1016/j.semarthrit.2013.09.008

@article{5002c011cc7c4a2eb569dce97ddd160a,

title = "Exposure to ACE inhibitors prior to the onset of scleroderma renal crisis-results from the international scleroderma renal crisis survey",

abstract = "Objective: To determine whether exposure to angiotensin-converting enzyme (ACE) inhibitors prior to the onset of scleroderma renal crisis (SRC) leads to worse outcomes of SRC. Methods: Prospective cohort study of incident SRC subjects. The exposure of interest was ACE inhibitors prior to the onset of SRC. The outcomes of interest were death or dialysis during the first year after the onset of SRC. Results: A total of 87 subjects with incident SRC were identified and 1-year follow-up data were obtained in 75 (86%) subjects. Overall, 27 (36%) subjects died within the first year and an additional 19 (25%) remained on dialysis 1 year after the onset of SRC. In adjusted analyses, exposure to ACE inhibitors prior to the onset of SRC was associated with an increased risk of death (hazard ratio 2.42, 95% CI 1.02, 5.75, p < 0.05 in the primary analysis and 2.17, 95% CI 0.88, 5.33, p = 0.09 after post-hoc adjustment for pre-existing hypertension). Conclusion: Overall, the 1-year outcomes of SRC were poor. Prior exposure to ACE inhibitors was associated with an increased risk of death after the onset of SRC, although there was uncertainty around the magnitude of the risk and the possibility of residual confounding could not be ruled out. Further studies will be needed to confirm these findings.",

keywords = "ACE inhibitors, Scleroderma, Scleroderma renal crisis",

author = "Marie Hudson and Murray Baron and Sol{\`e}ne Tatibouet and Furst, {Daniel E.} and Dinesh Khanna and Laura Hummers and Eric Hachulla and Thomas Medsger and Virginia Steen and Firas Alkassab and Sindhu Johnson and Oyvind Midtvedt and Gabriella Szucs and Elena Schiopu and Carreira, {Patricia E.} and Derk, {Chris T.} and Oliver Distler and Murat Inanc and Nader Khalidi and Mahmud, {Tafazzul H.} and Mayes, {Maureen D.} and Kevin McKown and Susanna Proudman and Lidia Rudnicka and Stuart Seigel and Jack Stein and Gabriele Valentini and Sule Yavuz and Hector Arbillaga and Beth Hazel and Jan Schulz and Milton Baker and Mike Becker and Jean Cabane and Andrew Chow and Romy Christmann and Philip Clements and Csuka, {Mary Ellen} and Katharina Hanke and Ina K{\"o}tter and Soren Jacobsen and Jason Kur and Lally, {Edward V.} and Sophie Ligier and Shikha Mittoo and Christine Peschken and {De La Pena-Lefebvre}, {Paloma Garcia} and Viviane Queyrel and Richard Silver and Robert Simms and Klaus Sondergaard and Yves Troyanov and Turi, {Maria C.} and John Varga and Vlachoyiannopoulos, {Panayiotis G.} and Voskuyl, {Alexandre E.} and Carol Yeadon and Rene Westhovens",

note = "Funding Information: Funding: This study was funded in part by the Fonds de la recherche en sant{\'e} du Qu{\'e}bec. Dr. Hudson is funded as a Chercheur-clinicien also by the Fonds de recherche en sant{\'e} du Qu{\'e}bec. ",

year = "2014",

month = apr,

doi = "10.1016/j.semarthrit.2013.09.008",

language = "English (US)",

volume = "43",

pages = "666--672",

journal = "Seminars in Arthritis and Rheumatism",

issn = "0049-0172",

publisher = "W.B. Saunders Ltd",

number = "5",

}

TY - JOUR

T1 - Exposure to ACE inhibitors prior to the onset of scleroderma renal crisis-results from the international scleroderma renal crisis survey

AU - Hudson, Marie

AU - Baron, Murray

AU - Tatibouet, Solène

AU - Furst, Daniel E.

AU - Khanna, Dinesh

AU - Hummers, Laura

AU - Hachulla, Eric

AU - Medsger, Thomas

AU - Steen, Virginia

AU - Alkassab, Firas

AU - Johnson, Sindhu

AU - Midtvedt, Oyvind

AU - Szucs, Gabriella

AU - Schiopu, Elena

AU - Carreira, Patricia E.

AU - Derk, Chris T.

AU - Distler, Oliver

AU - Inanc, Murat

AU - Khalidi, Nader

AU - Mahmud, Tafazzul H.

AU - Mayes, Maureen D.

AU - McKown, Kevin

AU - Proudman, Susanna

AU - Rudnicka, Lidia

AU - Seigel, Stuart

AU - Stein, Jack

AU - Valentini, Gabriele

AU - Yavuz, Sule

AU - Arbillaga, Hector

AU - Hazel, Beth

AU - Schulz, Jan

AU - Baker, Milton

AU - Becker, Mike

AU - Cabane, Jean

AU - Chow, Andrew

AU - Christmann, Romy

AU - Clements, Philip

AU - Csuka, Mary Ellen

AU - Hanke, Katharina

AU - Kötter, Ina

AU - Jacobsen, Soren

AU - Kur, Jason

AU - Lally, Edward V.

AU - Ligier, Sophie

AU - Mittoo, Shikha

AU - Peschken, Christine

AU - De La Pena-Lefebvre, Paloma Garcia

AU - Queyrel, Viviane

AU - Silver, Richard

AU - Simms, Robert

AU - Sondergaard, Klaus

AU - Troyanov, Yves

AU - Turi, Maria C.

AU - Varga, John

AU - Vlachoyiannopoulos, Panayiotis G.

AU - Voskuyl, Alexandre E.

AU - Yeadon, Carol

AU - Westhovens, Rene

N1 - Funding Information: Funding: This study was funded in part by the Fonds de la recherche en santé du Québec. Dr. Hudson is funded as a Chercheur-clinicien also by the Fonds de recherche en santé du Québec.

PY - 2014/4

Y1 - 2014/4

N2 - Objective: To determine whether exposure to angiotensin-converting enzyme (ACE) inhibitors prior to the onset of scleroderma renal crisis (SRC) leads to worse outcomes of SRC. Methods: Prospective cohort study of incident SRC subjects. The exposure of interest was ACE inhibitors prior to the onset of SRC. The outcomes of interest were death or dialysis during the first year after the onset of SRC. Results: A total of 87 subjects with incident SRC were identified and 1-year follow-up data were obtained in 75 (86%) subjects. Overall, 27 (36%) subjects died within the first year and an additional 19 (25%) remained on dialysis 1 year after the onset of SRC. In adjusted analyses, exposure to ACE inhibitors prior to the onset of SRC was associated with an increased risk of death (hazard ratio 2.42, 95% CI 1.02, 5.75, p < 0.05 in the primary analysis and 2.17, 95% CI 0.88, 5.33, p = 0.09 after post-hoc adjustment for pre-existing hypertension). Conclusion: Overall, the 1-year outcomes of SRC were poor. Prior exposure to ACE inhibitors was associated with an increased risk of death after the onset of SRC, although there was uncertainty around the magnitude of the risk and the possibility of residual confounding could not be ruled out. Further studies will be needed to confirm these findings.

AB - Objective: To determine whether exposure to angiotensin-converting enzyme (ACE) inhibitors prior to the onset of scleroderma renal crisis (SRC) leads to worse outcomes of SRC. Methods: Prospective cohort study of incident SRC subjects. The exposure of interest was ACE inhibitors prior to the onset of SRC. The outcomes of interest were death or dialysis during the first year after the onset of SRC. Results: A total of 87 subjects with incident SRC were identified and 1-year follow-up data were obtained in 75 (86%) subjects. Overall, 27 (36%) subjects died within the first year and an additional 19 (25%) remained on dialysis 1 year after the onset of SRC. In adjusted analyses, exposure to ACE inhibitors prior to the onset of SRC was associated with an increased risk of death (hazard ratio 2.42, 95% CI 1.02, 5.75, p < 0.05 in the primary analysis and 2.17, 95% CI 0.88, 5.33, p = 0.09 after post-hoc adjustment for pre-existing hypertension). Conclusion: Overall, the 1-year outcomes of SRC were poor. Prior exposure to ACE inhibitors was associated with an increased risk of death after the onset of SRC, although there was uncertainty around the magnitude of the risk and the possibility of residual confounding could not be ruled out. Further studies will be needed to confirm these findings.

KW - ACE inhibitors

KW - Scleroderma

KW - Scleroderma renal crisis

UR - http://www.scopus.com/inward/record.url?scp=84898780891&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84898780891&partnerID=8YFLogxK

U2 - 10.1016/j.semarthrit.2013.09.008

DO - 10.1016/j.semarthrit.2013.09.008

M3 - Article

C2 - 24176729

AN - SCOPUS:84898780891

SN - 0049-0172

VL - 43

SP - 666

EP - 672

JO - Seminars in Arthritis and Rheumatism

JF - Seminars in Arthritis and Rheumatism

IS - 5

ER -

Exposure to ACE inhibitors prior to the onset of scleroderma renal crisis-results from the international scleroderma renal crisis survey

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this