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The development and progression of interstitial lung disease in systemic sclerosis can be an ominous finding. A new analysis of two independent clinical trial cohorts shows that oxygen saturation (SpO2) < 94% after 6 minute walk time (6MWT) and the presence of arthritis predicted the development of ILD in SSc. (SPAR: SPO2 and ARthritis)
A total of 215 SSc patients with mild ILD (without pulmonary HTN or COPD) were followed prospectively with SpO2 levels, high-resolution computed tomography (HRCT) and pulmonary function tests.
ILD progression was defined as a relative decrease in forced vital capacity (FVC) ≥15%, or FVC ≥10% combined with diffusing capacity for carbon monoxide (DLCO) ≥15% at 1-year.
Between 21-26% of SSc patients showed ILD progression. Independent predictors of progression included lower SpO2 after 6MWT and arthritis.
This SPAR model (SPO2 and ARthritis) increased the prediction rate from 25.5% to 91.7% with an area under the curve of 0.83 (95% CI: 0.73 to 0.93).
These simple measures might be helpful for the risk stratification of SSc patients.