{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:12:15Z","timestamp":1790719935040,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Pulmonary hypertension (PH) is a serious complication of systemic sclerosis (SSc). In this study, we explored the prediction of short\u2010term risk for PH using serial pulmonary function tests (PFTs) and other disease features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>SSc patients in whom disease onset occurred \u226510\u2009years prior to data retrieval and for whom autoantibody specificity and PFT data were available were included in this study. Mixed\u2010effects modeling was used to describe changes in PFTs over time. Landmarking was utilized to include serial assessments and stratified Cox proportional hazards regression analysis with landmarks as strata was used to develop the PH prediction models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analyzed data from 1,247 SSc patients, 16.3% of whom were male and 35.8% of whom had diffuse cutaneous SSc. Anticentromere, antitopoisomerase, and anti\u2013RNA polymerase antibodies were observed in 29.8%, 22.0%, and 11.4% of patients, respectively, and PH developed in 13.6% of patients. Over time, diffusing capacity for carbon monoxide (DL<jats:sc>co<\/jats:sc>) and carbon monoxide transfer coefficient (K<jats:sc>co<\/jats:sc>) declined in all SSc patients (up to 1.5% per year) but demonstrated much greater annual decline (up to 4.5% and 4.8%, respectively) in the 5\u20137\u2009years preceding PH diagnosis. Comparisons between multivariable models including either DL<jats:sc>co<\/jats:sc>, K<jats:sc>co<\/jats:sc>, or forced vital capacity (FVC)\/DL<jats:sc>co<\/jats:sc> ratio, demonstrated that both absolute values and change over the preceding year in those measurements were strongly associated with the risk of PH (hazard ratio [HR] 0.93 and 0.76 for K<jats:sc>co<\/jats:sc> and its change; HR 0.90 and 0.96 for DL<jats:sc>co<\/jats:sc> and its change; and HR 1.08 and 2.01 for FVC\/DL<jats:sc>co<\/jats:sc> ratio and its change; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 for all). The K<jats:sc>co<\/jats:sc>\u2010based model had the greatest discriminating ability (Harrell's C\u2010statistic 0.903).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings strongly support the importance of PFT trends over time in identifying patients at risk of developing PH.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.42349","type":"journal-article","created":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T14:59:27Z","timestamp":1663599567000},"page":"449-458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Dynamic Prediction of Pulmonary Hypertension in Systemic Sclerosis Using Landmark Analysis"],"prefix":"10.1002","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5178-9038","authenticated-orcid":false,"given":"Svetlana I.","family":"Nihtyanova","sequence":"first","affiliation":[{"name":"Centre for Rheumatology and Connective Tissue Diseases Royal Free Hospital, London, UK, and GSK  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin E.","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Service Royal Free Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Voon H.","family":"Ong","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology and Connective Tissue Diseases Royal Free Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athol U.","family":"Wells","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.","family":"Coghlan","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension Service Royal Free Hospital  London 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