{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:38:14Z","timestamp":1784299094086,"version":"3.55.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008897","name":"Janssen Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008897","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scleroderma Australia"},{"DOI":"10.13039\/501100023332","name":"Scleroderma Victoria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023332","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"}]},{"name":"Musculoskeletal Australia"},{"name":"Australian Rheumatology Association"},{"name":"St Vincent's Hospital Melbourne Research Endowment Fund"},{"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\/501100000948","name":"Pfizer Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000948","id-type":"DOI","asserted-by":"publisher"}]},{"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\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005205","name":"AstraZeneca Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005205","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Digital ulcers (DU) are a common, severe vascular manifestation of systemic sclerosis (SSc) with few effective treatment options. Using data from the Australian Scleroderma Cohort Study (ASCS), we sought to evaluate the effect of calcium channel blockers (CCB) on the treatment and prevention of DU.<\/jats:p><jats:p>Using data from 1953 participants, with a median of 4.34\u00a0years of follow-up, we used generalised estimating equations to evaluate the clinical characteristics associated with CCB use and ascertain the risk factors for the presence of DU at subsequent study visits. A time-dependent Cox-proportional hazard model was applied to evaluate the risk of future occurrence of DU with CCB use.<\/jats:p><jats:p>Sixty-six percent of participants received CCB and patients with a history of DU were more likely to be prescribed a CCB (76.76% vs 53.70%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). CCB use was more frequent in patients with severe complications of DU including chronic DU (OR 1.47, <jats:italic>p<\/jats:italic>\u2009=\u20090.02), need for hospitalisation for iloprost (OR 1.30, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) or antibiotics (OR 1.36, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) and digital amputation (OR 1.48, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Use of CCB was more likely in patients who experienced  DU at subsequent study visits (OR 1.32, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and was not associated with a decreased risk of the development of a first DU (HR 0.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.65).<\/jats:p><jats:p>CCB are frequently used in the management of SSc in the ASCS and their use is associated with severe peripheral vascular manifestations of SSc. However, our results suggest that CCB may not be effective in the healing or prevention of DU.<\/jats:p><jats:p><jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"3\"><jats:bold>Key Points<\/jats:bold><jats:italic>\u2022 Calcium channel blockers (CCB) are commonly used in patients with vascular manifestations of systemic sclerosis (SSc).<\/jats:italic><jats:italic>\u2022 CCB did not reduce the risk of the development of the first episode of digital ulcers when used prior to the onset of SSc digital ulcers.<\/jats:italic><jats:italic>\u2022 CCB use was not associated with a reduction in the rate of digital ulcer recurrence.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s10067-023-06796-1","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T06:01:46Z","timestamp":1698991306000},"page":"269-276","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The effect of calcium channel blockers on digital ulcers in systemic sclerosis: data from a prospective cohort study"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4636-729X","authenticated-orcid":false,"given":"Laura","family":"Ross","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Maltez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Morrisroe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimti","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Sahhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene-Siew","family":"Ngian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Host","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandana","family":"Nikpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Proudman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"key":"6796_CR1","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1002\/art.40027","volume":"69","author":"Y Hao","year":"2017","unstructured":"Hao Y, Hudson M, Baron M, Carreira P, Stevens W, Rabusa C et al (2017) Early mortality in a multinational systemic sclerosis inception cohort. 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