Academic Journal
Effectiveness of oral anticoagulants in precapillary pulmonary hypertension associated with systemic sclerosis: a EUSTAR cohort study.
| Τίτλος: | Effectiveness of oral anticoagulants in precapillary pulmonary hypertension associated with systemic sclerosis: a EUSTAR cohort study. |
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| Συγγραφείς: | Farina N; Department of Experimental and Clinical Medicine, Scleroderma Unit, Division of Rheumatology, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy., Bellando Randone S; Department of Experimental and Clinical Medicine, Scleroderma Unit, Division of Rheumatology, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence, Italy., Jenssen-Bjørkekjær H; Department of Rheumatology, Hospital of Southern Norway, Kristiansand, Norway., Sanges S; National Reference Center for Pulmonary Arterial Hypertension (Pulmotension), Lille, France.; Inserm, CHU Lille, Department of Internal Medicine and Clinical Immunology, Reference Center for Rare Autoimmune and Autoinflammatory diseases (CERAINOM), U1286 - INFINITE-Institute for Translational Research in Inflammation, University of Lille, Lille, France., Carreira P; Rheumatology Department, Hospital Universitario, Madrid, Spain., Airò P; Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy., Guiducci S; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy., Giuggioli D; Scleroderma Unit, Rheumatology Unit, University Hospital of Modena and Reggio Emilia, Modena, Italy., Riemekasten G; Klinik für Rheumatologie und klinische Immunologie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany., Simeón Aznar CP; Department of Internal Medicine, Systemic Autoimmune Diseases Unit, Hospital Universitario Vall d'Hebron, Barcelona, Spain., Bergmann C; Department Internal Medicine 3, University Hospital Erlangen, Erlangen, Germany., Siegert E; Department of Rheumatology, Charité University Hospital, Berlin, Germany., Castellví I; Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Saketkoo LA; New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, United States., de Vries-Bouwstra J; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands., Klemm P; Department of Rheumatology and Clinical Immunology Center, JLU Giessen, Bad Nauheim, Germany., Müller-Ladner U; Department of Rheumatology and Clinical Immunology Center, JLU Giessen, Bad Nauheim, Germany., Balbir-Gurman A; Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel., Smith V; Department of Rheumatology, University of Ghent, Ghent, Belgium., Iannone F; Rheumatology DiMePReJ, University of Bari School of Medicine, Bari, Italy., Idolazzi L; Section of Rheumatology, Department of Medicine, University of Verona, Verona, Italy., Denton C; Centre for Rheumatology, Royal Free London and University College London Medical School, London, United Kingdom., Rosato E; Department of Translational and Precision Medicine, Azienda Ospedaliero-Universitaria Policlinico Umberto 1-Centro di riferimento regionale per la sclerosi sistemica, Sapienza University of Rome, Rome, Italy., Maurer B; Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Allanore Y; Rheumatology Department, Université Paris Cité, Cochin Hospital, Paris, France., Tanaka Y; Department of Molecular Targeted Therapeutics, First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyūshū, Japan., Zanatta E; Rheumatology Unit, Padova University Hospital, Padova, Italy., Truchetet ME; Rheumatology Department, CHU de Bordeaux, Bordeaux, France., Kuwana M; Nippon Medical School Hospital, Tokyo, Japan., Martin M; Department of Internal Medicine, Poitiers University Hospital, Poitiers, France., Cauli A; Department of Medical Sciences and Public Health, Rheumatology Unit, AOU and University of Cagliari, Monserrato, Cagliari, Italy., Solanki K; Rheumatology Unit, Te Whatu Ora Health NZ - Waikato, Waikato School of Medicine, Hamilton, New Zealand., Del Galdo F; Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds Raynaud's and Scleroderma Program, NIHR Biomedical Research Centre, Leeds, United Kingdom., Gheorghiu AM; Internal Medicine and Rheumatology Department, Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Ion Cantacuzino Hospital, Bucharest, Romania., Anic B; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb, School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia., Boleto G; Department of Rheumatology, Faculdade de Medicina, ULS Santa Maria, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal., Kumánovics G; Department of Rheumatology and Immunology, University of Pécs, Medical School, Pecs, Hungary., Andréasson K; Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden., Rednic S; Clinica Reumatologie, University of Medicine and Pharmacy Iuliu Hatieganu Cluj, Cluj-Napoca, Romania., Chung LS; Department of Medicine, Stanford University School of Medicine, Stanford, United States., Oliveira S; Department of Medicine IV, Systemic Immunomediated Diseases Unit, Fernando Fonseca Hospital, Amadora, Portugal., Cadar M; Rheumatology Clinic, Sapienza University of Rome, Rome, Italy., Corrado A; Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy., de Souza Müller C; Rheumatology Division, Hospital de Clinicas da Universidade Federal do Parana, Curitiba, Brazil., Hsu VM; Rutgers-RWJ Scleroderma Program, New Brunswick, United States., Levy Y; Meir Medical Center, Tel-Aviv University, Kfar-Saba, Israel., Moroncini G; Department of Internal Medicine, Marche University Hospital, Clinica Medica, Ancona, Italy., Henes J; Department for Internal Medicine II (Haematology, Oncology, Rheumatology and Clinical Immunology), University Hospital Tuebingen, Tuebingen, Germany., Balanescu A; Department of Internal Medicine and Rheumatology, 'Carol Davila' University of Medicine and Pharmacy, 'Sf. Maria' Hospital, Bucharest, Romania., De Langhe E; Department of Development and Regeneration, University Hospital Leuven, Laboratory of Tissue Homeostasis and Disease, KU Leuven, Leuven, Belgium., Montecucco C; Rheumatology Unit, Università di Pavia e IRCCS Fondazione Policlinico S. Matteo, Pavia, Italy., Sfikakis PP; Rheumatology Unit, Athens University Medical School, First Propaedeutic and Internal Medicine, Athens, Greece., Iudici M; Division of Rheumatology, Geneva University Hospitals, Hôpital Beau-Séjour, Geneva, Switzerland., Heitmann S; Department of Rheumatology, Marienhospital Stuttgart, Stuttgart, Germany., Vonk MC; Department of Rheumatology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands., Hoffmann-Vold AM; Department of Rheumatology, Oslo University Hospital, Oslo, Norway., Distler O; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Matucci Cerinic M; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy.; Inflammation, Fibrosis and Ageing Initiative (INFLAGE), IRCCS San Raffaele Hospital, Milan, Italy.; Medical Faculty, Vita-Salute San Raffaele University, Milan, Italy., Bruni C; Department of Experimental and Clinical Medicine, Scleroderma Unit, Division of Rheumatology, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. |
| Πηγή: | Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2026 Oct 01; Vol. 65 (10). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Oxford University Press Country of Publication: England NLM ID: 100883501 Publication Model: Print Cited Medium: Internet ISSN: 1462-0332 (Electronic) Linking ISSN: 14620324 NLM ISO Abbreviation: Rheumatology (Oxford) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford, UK : Avenel, N.J. : Oxford University Press ; Distributed by Mercury International, c1999- |
| Ιατρικοί όροι (MeSH): | Scleroderma, Systemic*/complications , Scleroderma, Systemic*/mortality , Hypertension, Pulmonary*/drug therapy , Hypertension, Pulmonary*/etiology , Hypertension, Pulmonary*/mortality , Hypertension, Pulmonary*/physiopathology , Anticoagulants*/therapeutic use , Anticoagulants*/administration & dosage, Humans ; Female ; Retrospective Studies ; Male ; Middle Aged ; Administration, Oral ; Aged ; Treatment Outcome ; Propensity Score ; Kaplan-Meier Estimate ; Cohort Studies |
| Περίληψη: | Objectives: The role of anticoagulation in systemic sclerosis (SSc) with precapillary pulmonary hypertension (PH) remains controversial, with conflicting evidence regarding its impact on survival, including potential harmful effects. Aiming to address this research gap, we evaluated both mortality and PH worsening in a large SSc-precapillary PH cohort, additionally accounting for SSc-specific risk factors in our analyses, to better inform individualized treatment decisions. Methods: This retrospective cohort study included SSc patients from the European Scleroderma Trials and Research database with precapillary PH confirmed by right heart catheterization (RHC). The association of oral anticoagulants (OAC) use with survival and PH worsening was assessed using Kaplan-Meier estimates and multivariable Cox regression models. To minimize confounding, propensity score matching was additionally performed. Results: Among 614 patients included, 143 (23%) received OAC at the time of RHC. At baseline, patients on OAC had worse hemodynamic parameters. No significant association was found between OAC use and survival (HR 0.983 95%CI 0.724-1.334) or PH worsening (HR 1.070 95%CI 0.811-1.412). These findings remained consistent after propensity score matching and in the subgroup of 230 SSc patients with precapillary PH without interstitial lung disease. Conclusion: In this large SSc cohort with precapillary PH, we did not observe any clinical benefit associated with OAC, neither in terms of survival nor of PH worsening. Further prospective studies are needed to determine whether specific patient subgroups may benefit from anticoagulation therapy. (© The Author(s) 2026. Published by Oxford University Press on behalf of the British Society for Rheumatology.) |
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| Contributed Indexing: | Keywords: anticoagulant; pulmonary hypertension; real-world; systemic sclerosis |
| Substance Nomenclature: | 0 (Anticoagulants) |
| Entry Date(s): | Date Created: 20260918 Date Completed: 20261012 Latest Revision: 20261014 |
| Update Code: | 20261014 |
| PubMed Central ID: | PMC13657258 |
| DOI: | 10.1093/rheumatology/keag516 |
| PMID: | 42758145 |
| Βάση Δεδομένων: | MEDLINE |
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