{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:09:36Z","timestamp":1790946576821,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["1\u2010R01\u2010AR081382\u201001A1"],"award-info":[{"award-number":["1\u2010R01\u2010AR081382\u201001A1"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30\u2010AR\u2010070254"],"award-info":[{"award-number":["P30\u2010AR\u2010070254"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Our objective was to identify patients with systemic sclerosis (SSc) with a high burden of autonomic symptoms and to determine whether they have a distinct clinical phenotype, gastrointestinal (GI) transit, or extraintestinal features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a prospective cohort of patients with SSc with GI disease, clinical data were systematically obtained at routine visits. Dysautonomia was identified by the Composite Autonomic Symptom Score (COMPASS)\u201031questionnaire. GI transit was measured by whole\u2010gut scintigraphy. Associations between total COMPASS\u201031 scores and clinical features, GI symptoms, and transit were evaluated. Comparisons between patients with global autonomic dysfunction (GAD; \u22655 positive COMPASS\u201031 subdomains) and those with limited autonomic dysfunction (LAD; &lt;5 positive subdomains) were also studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 91 patients with SSc and GI involvement were included (mean age 57 years, 90% female, 74% limited cutaneous disease, 83% significant GI disease [Medsger score \u22652]). The mean COMPASS\u201031 score in patients with SSc was higher than controls (38.8 vs 7.2); 33% had GAD, and 67% had LAD. Patients with GAD were more likely to have limited SSc (93% vs 65%; <jats:italic>P<\/jats:italic> &lt; 0.01) and have sicca symptoms (100% vs 77%; <jats:italic>P<\/jats:italic> = 0.01). Gastric and colonic transit were faster in patients with GAD (<jats:italic>P<\/jats:italic> &lt; 0.05). Upper GI involvement (Medsger GI score of 1 or 2) was associated with higher total COMPASS\u201031 scores (<jats:italic>P<\/jats:italic> = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Symptoms of global dysautonomia are seen in up to one\u2010third of patients with SSc and GI involvement. Identifying specific clinical characteristics associated with GAD in SSc will help to identify a population that may benefit from therapies that modulate the autonomic nervous system.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr25411-toc-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25411","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T01:30:35Z","timestamp":1723426235000},"page":"1675-1685","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Evaluating the Associations Among Dysautonomia, Gastrointestinal Transit, and Clinical Phenotype in Patients With Systemic 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