{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:50:09Z","timestamp":1787788209148,"version":"build-2784847793"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T00:00:00Z","timestamp":1617408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002491","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005646","name":"Actelion Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005646","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001203","name":"GlaxoSmithKline Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001203","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000940","name":"Arthritis Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000940","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the clinical characteristics and outcomes of systemic sclerosis\u2013mixed connective tissue disease (SSc\u2013MCTD) and SSc overlap syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included patients from the Australian Scleroderma Cohort Study who met American College of Rheumatology\/European Alliance of Associations for Rheumatology criteria for SSc. Three mutually exclusive groups were created: SSc\u2013MCTD, SSc overlap, and SSc only. Univariate comparison of clinical features was performed by analysis of variance or chi\u2010square test. Survival analysis was performed using Kaplan\u2010Meier (KM) curves and Cox proportional hazards regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1,728 patients, 97 (5.6%) had SSc\u2013MCTD, and 126 (7.3%) had SSc overlap. Those with MCTD\u2013SSc were more commonly Asian (18.3% versus 10.1% in SSc overlap, and 3.6% in SSc only; <jats:italic>P<\/jats:italic> &lt; 0.0001) and younger at disease onset (38.4 years versus 46.5 or 46.8 years, <jats:italic>P<\/jats:italic> &lt; 0.0001). Those with SSc\u2013MCTD or SSc overlap were more likely to have limited cutaneous SSc. All 3 groups had similar frequency of interstitial lung disease (ILD), although pulmonary arterial hypertension (PAH) was less common in SSc overlap. Synovitis and myositis were more common in SSc overlap and SSc\u2013MCTD than in SSc only. KM curves showed better survival in SSc\u2013MCTD than SSc overlap or SSc only (<jats:italic>P =<\/jats:italic> 0.011), but this was not significant after adjustment for sex and age at disease onset. SSc\u2010specific antibodies were survival prognostic markers, with antinuclear antibody centromere or anti\u2010RNP conferring better survival than anti\u2013Scl\u201070 or anti\u2013RNA polymerase III (<jats:italic>P =<\/jats:italic> 0.005). Patients with SSc\u2013MCTD and SSc overlap had lower mortality following diagnosis of ILD and PAH than patients with SSc only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides insights into the clinical characteristics of patients with SSc\u2013MCTD, SSc overlap, and SSc only and shows that anti\u2010RNP antibodies are associated with better survival than anti\u2013Scl\u201070 and anti\u2010RNA polymerase III antibodies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24167","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T10:50:50Z","timestamp":1581677450000},"page":"732-741","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Clinical Features of Systemic Sclerosis\u2013Mixed Connective Tissue Disease and Systemic Sclerosis Overlap Syndromes"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4140-2711","authenticated-orcid":false,"given":"Jessica L.","family":"Fairley","sequence":"first","affiliation":[{"name":"The Alfred Hospital and Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Hansen","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Proudman","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital and University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Sahhar","sequence":"additional","affiliation":[{"name":"Monash Health and Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene\u2010Siew","family":"Ngian","sequence":"additional","affiliation":[{"name":"Monash Health and Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Walker","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Strickland","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Wilson","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3840-3967","authenticated-orcid":false,"given":"Kathleen","family":"Morrisroe","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nava","family":"Ferdowsi","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3464-7438","authenticated-orcid":false,"given":"Gabor","family":"Major","sequence":"additional","affiliation":[{"name":"Royal Newcastle Centre John Hunter Hospital and University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Roddy","sequence":"additional","affiliation":[{"name":"Fiona Stanley Hospital  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Stevens","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandana","family":"Nikpour","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital Melbourne, Melbourne, and The University of Melbourne at St Vincent\u2019s Hospital (Melbourne)  Fitzroy Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Australian Scleroderma Interest 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