{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T03:49:53Z","timestamp":1781063393448,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006388","name":"H\u00f4pitaux Universitaires de Gen\u00e8ve","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006388","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":[[2025,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study is to evaluate whether adding oral glucocorticoids to immunosuppressive therapy improves skin scores and ensures safety in patients with early diffuse cutaneous systemic sclerosis (dcSSc).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed an emulated randomized trial comparing the changes from baseline to 12 \u00b1 3 months of the modified Rodnan skin score (mRSS: primary outcome) in patients with early dcSSc receiving either oral glucocorticoids (\u226420 mg\/day prednisone equivalent) combined with immunosuppression (treated) or immunosuppression alone (controls), using data from the European Scleroderma Trials and Research Group. Secondary end points were the difference occurrence of progressive skin or lung fibrosis and scleroderma renal crisis. Matching propensity score was used to adjust for baseline imbalance between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We matched 208 patients (mean age 49 years; 33% male; 59% anti\u2010Scl70), 104 in each treatment group, obtaining comparable characteristics at baseline. In the treated group, patients received a median prednisone dose of 5 mg\/day. Mean mRSS change at 12 \u00b1 3 months was similar in the two groups (decrease of 2.7 [95% confidence interval {95% CI} 1.4\u20134.0] in treated vs 3.1 [95% CI 1.9\u20134.4] in control, <jats:italic>P<\/jats:italic> = 0.64). Similar results were observed in patients with shorter disease duration (\u2264 24 months) or with mRSS \u226422. There was no between\u2010group difference for all prespecified secondary outcomes. A case of scleroderma renal crisis occurred in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We did not find any significant benefit of adding low\u2010dose oral glucocorticoids to immunosuppression for skin fibrosis, and at this dosage, glucocorticoid did not increase the risk of scleroderma renal crisis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25469","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T22:24:08Z","timestamp":1731623048000},"page":"649-657","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Oral Glucocorticoids for Skin Fibrosis in Early Diffuse Systemic Sclerosis: A Target Trial Emulation Study From the European Scleroderma Trials and Research Group Database"],"prefix":"10.1002","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4801-8395","authenticated-orcid":false,"given":"Denis","family":"Mongin","sequence":"first","affiliation":[{"name":"Geneva University Hospitals  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Matucci\u2010Cerinic","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Scientific Institute, IRCCS San Raffaele Hospital, and Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich A.","family":"Walker","sequence":"additional","affiliation":[{"name":"University Hospital Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0546-8310","authenticated-orcid":false,"given":"Oliver","family":"Distler","sequence":"additional","affiliation":[{"name":"University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radim","family":"Becvar","sequence":"additional","affiliation":[{"name":"University  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Siegert","sequence":"additional","affiliation":[{"name":"Charit\u00e9 University Hospital  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia P.","family":"Ananyeva","sequence":"additional","affiliation":[{"name":"V.A. Nasonova Research Institute of Rheumatology Russian Federation  Moskow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Smith","sequence":"additional","affiliation":[{"name":"Ghent University, Ghent University Hospital, and VIB Inflammation Research Center  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1641-0875","authenticated-orcid":false,"given":"Juan Jose","family":"Alegre\u2010Sancho","sequence":"additional","affiliation":[{"name":"Hospital Universitario Doctor Peset  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sule","family":"Yavuz","sequence":"additional","affiliation":[{"name":"Istanbul Bilim University  Altunizade\u2010Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Limonta","sequence":"additional","affiliation":[{"name":"ASST Papa Giovanni XXIII  Begamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Riemekasten","sequence":"additional","affiliation":[{"name":"Klinik F\u00fcr Rheumatologie Und Klinische Immunologie, Universit\u00e4tsklinikum Schleswig\u2010Holstein  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8175-2583","authenticated-orcid":false,"given":"Elena","family":"Rezus","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, Rehabilitation Hospital Iasi  Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-9907","authenticated-orcid":false,"given":"Madelon","family":"Vonk","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Elise","family":"Truchetet","sequence":"additional","affiliation":[{"name":"National Reference Center for Systemic Autoimmune Rare Diseases, Bordeaux University Hospital, H\u00f4pital Pellegrin  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8528-2283","authenticated-orcid":false,"given":"Francesco","family":"Del Galdo","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds  Leeds United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine S.","family":"Courvoisier","sequence":"additional","affiliation":[{"name":"Geneva University Hospitals  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5871-8806","authenticated-orcid":false,"given":"Michele","family":"Iudici","sequence":"additional","affiliation":[{"name":"Geneva University Hospitals  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EUSTAR Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200742"},{"issue":"2","key":"e_1_2_6_3_1","first-page":"202","article-title":"Scleroderma (systemic sclerosis): classification, subsets and pathogenesis","volume":"15","author":"LeRoy EC","year":"1988","journal-title":"J Rheumatol"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00765-9"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.6368"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew224"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209909"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2023-eular.1383"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40560"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2634"},{"issue":"2","key":"e_1_2_6_11_1","first-page":"157","article-title":"Glucocorticoids in systemic sclerosis: weighing the benefits and risks \u2010 a systematic review","volume":"31","author":"Iudici M","year":"2013","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-003-0733-2"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00300808"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead012"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-013-2422-0"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac533"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0597-x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2022-071108","article-title":"Target trial emulation: applying principles of randomised trials to observational studies","volume":"378","author":"Matthews AA","year":"2022","journal-title":"BMJ"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.062901"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38098"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq355"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205226"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24380"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200106)44:6<1351::AID-ART227>3.0.CO;2-I"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-217455"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-213201"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211912"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24681"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208024"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11165"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470316696"},{"key":"e_1_2_6_32_1","unstructured":"R Core Team.R: A Language and Environment for Statistical Computing. 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