{
  "abstract": "Objectives To evaluate whether patients with systemic lupus erythematosus (SLE) have different nailfold videocapillaroscopy (NVC) findings compared with healthy controls (HCs) and whether there is an association between NVC abnormalities and disease activity, clinical and/or laboratory features in SLE.Methods This is an observational, multicentre, international, matched case–control study. 381 subjects (203 patients with SLE and 178 HCs) were enrolled from 16 centres in 10 countries. Clinical and laboratory data were collected using ad hoc forms. 5861 NVC images were acquired, coded and uploaded for central blinded analysis.Results A normal NVC pattern was observed in most patients with SLE (86.6%) and, a significantly higher frequency of NVC abnormalities such as enlarged and giant capillaries, microhaemorrhages and irregular nail bed architecture (p<0.001) were found in the remaining patients. Multiple correspondence analysis outlined two NVC patterns, one of which, the more severe (cluster 2), present in 12% of patients, was characterised by a higher prevalence of lower capillary density, abnormally shaped and enlarged capillaries and irregular nail bed architecture. NVC cluster 2 had significantly higher disease activity compared with cluster 1 for both Systemic Lupus Erythematosus Disease Activity Index cut-off points ≥3 and ≥4 (p=0.016 and p=0.028, respectively). SLE with ‘more severe’ NVC pattern (cluster 2) have a significantly higher frequency of arthritis, renal involvement and ongoing glucocorticoid therapy, whereas serositis was significantly associated with ‘less severe’ NVC pattern (cluster 1).Conclusions This study has shown that changes in NVC patterns are associated with important aspects of SLE disease activity. Future prospective studies are needed to further support the use of NVC in SLE monitoring.Trial registration number NCT02801812.",
  "authors": [
    {
      "affiliations": [
        "Clinica Reumatologica, Dipartimento di Reumatologia e Scienze Mediche, ASST Gaetano Pini-CTO, Dipartimento di Scienze Cliniche e di Comunità, Dipartimento di Eccellenza 2023-2027, Università degli Studi di Milano, Milano, Italy"
      ],
      "name": "Francesca Ingegnoli"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"
      ],
      "name": "Nicola Ughi"
    },
    {
      "affiliations": [
        "Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"
      ],
      "name": "Valeria Riccieri"
    },
    {
      "affiliations": [
        "Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"
      ],
      "name": "Katia Stefanantoni"
    },
    {
      "affiliations": [
        "HP2 Laboratory, Pharmacovigilance Unit, Inserm U1300, Grenoble Alpes University Hospital, Univ Grenoble Alpes, Grenoble, France"
      ],
      "name": "Jean-Luc Cracowski"
    },
    {
      "affiliations": [
        "Center of Excellence in Rheumatic and Musculoskeletal Disorders, Mexico City, Mexico"
      ],
      "name": "Marwin Gutierrez"
    },
    {
      "affiliations": [
        "Laboratory of Experimental Rheumatology and Academic Division of Rheumatology, University of Genova, IRCCS Ospedale Policlinico San Martino, Genova, Italy"
      ],
      "name": "Alberto Sulli"
    },
    {
      "affiliations": [
        "Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico"
      ],
      "name": "Tatiana S Rodriguez-Reyna"
    },
    {
      "affiliations": [
        "Helsinki University Hospital (HUS), Helsinki, Finland"
      ],
      "name": "Alexandra Hame"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Ashima Makol"
    },
    {
      "affiliations": [
        "Hospital Universitario Puerta de Hierro, Madrid, Spain"
      ],
      "name": "Laura Nuño-Nuño"
    },
    {
      "affiliations": [
        "Servicio de Reumatología, Hosp Gen Univ Gregorio Maranon, Madrid, Spain"
      ],
      "name": "Juan Carlos Nieto-Gonzalez"
    },
    {
      "affiliations": [
        "The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan"
      ],
      "name": "Satoshi Kubo"
    },
    {
      "affiliations": [
        "Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, Poland"
      ],
      "name": "Malgorzata Michalska-Jakubus"
    },
    {
      "affiliations": [
        "S. Reumatología IIS-HU, Fundación Jiménez Díaz, Madrid, Spain"
      ],
      "name": "Olga Sanchez Pernaute"
    },
    {
      "affiliations": [
        "Rheumatology Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Jesi (Ancona), Italy"
      ],
      "name": "Rossella De Angelis"
    },
    {
      "affiliations": [
        "Centre for Musculoskeletal Research, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UK"
      ],
      "name": "Ariane L Herrick"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Department of Internal Medicine, Ghent University Hospital, Unit for Molecular Immunology and Inflammation, Flemish Institute for Biotechnology, Inflammation Research Center, University of Ghent, Ghent, Belgium",
        "Frailty in Ageing research unit (FRIA), Vitality research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium",
        "Rheumatology department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium"
      ],
      "name": "Karin Melsens"
    },
    {
      "affiliations": [
        "Laboratory of Experimental Rheumatology and Academic Division of Rheumatology, University of Genova, IRCCS Ospedale Policlinico San Martino, Genova, Italy"
      ],
      "name": "Maurizio Cutolo"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Department of Internal Medicine, Ghent University Hospital, Unit for Molecular Immunology and Inflammation, Flemish Institute for Biotechnology, Inflammation Research Center, University of Ghent, Ghent, Belgium"
      ],
      "name": "Vanessa Smith"
    },
    {
      "affiliations": [],
      "name": "on behalf of the EULAR Study Group on Microcirculation in Rheumatic Diseases collaborators"
    }
  ],
  "title": "Distribution of nailfold videocapillaroscopy parameters in systemic lupus erythematosus and their association with disease activity: an international blinded case–control analysis on behalf of the EULAR study group on microcirculation in rheumatic diseases",
  "uid": "72087630-4f50-515b-ab6c-6a463b802b7f"
}