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Authors
Abstract(s)
Introdução: Na Esclerose Sistémica, a osteólise é uma manifestação potencialmente
incapacitante ainda pouco estudada.
Objetivo: Realizar uma scoping review sobre a osteólise na Esclerose Sistémica,
sumariando o conhecimento e identificando áreas que mais carecem de investigação.
Métodos: Esta revisão foi realizada de acordo com as recomendações Preferred Reporting
Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.
Resultados: Foram incluídos 31 artigos para análise. As publicações incluídas revelaramse heterogéneas quanto à população e critérios de inclusão. O défice de meios
estandardizados para o diagnóstico e classificação de osteólise agravou estas desigualdades.
A maioria dos estudos relatou localizações/prevalência de osteólise e associações com
outras manifestações, sendo que apenas uma minoria se foca sobre outros tópicos,
especialmente fatores preditores de evolução de osteólise e valor prognóstico da mesma.
Nenhum autor abordou o tratamento.
A localização mais analisada e prevalente foi a acro-osteólise. A Esclerose Sistémica difusa
foi o subtipo cutâneo mais associado a acro-osteólise. O anticorpo anti-Topoisomerase I foi
o anticorpo específico de Esclerose Sistémica com maior relação com acro-osteólise. A
duração da doença, a calcinose e as úlceras digitais foram as manifestações mais associadas,
mas apenas as últimas duas mostraram predizer acro-osteólise. A ecografia demonstrou
elevada sensibilidade para o diagnóstico, mas é necessário estudar a sua aplicabilidade.
Conclusões: Apesar do impacto que a osteólise tem nos indivíduos com Esclerose
Sistémica, continua a existir uma carência importante de estudos que se foquem nesta
temática. Destaca-se a ausência de trabalhos centrados na abordagem terapêutica bem
como a paucidade de estudos longitudinais de qualidade que permitam avaliar
fidedignamente o seu valor prognóstico e os seus preditores de evolução.
Introduction: In Systemic Sclerosis, osteolysis is a potentially disabling musculoskeletal manifestation still poorly studied. Objective: To perform a scoping review focusing on osteolysis in Systemic Sclerosis, in order to summarize knowledge and identify areas that need further investigation. Methods: This review was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews recommendations. Results: 31 articles were included for analysis. The publications included proved to be heterogeneous regarding the population and inclusion criteria. The lack of standardized means for the diagnosis and classification of osteolysis exacerbated these inequalities. Most studies reported locations/prevalence of osteolysis and associations with other manifestations, with only a minority focusing on other topics, especially progression predictors of osteolysis and its prognostic value. None of the authors addressed treatment. The most frequently analyzed and prevalent location was acro-osteolysis. Diffuse Systemic Sclerosis was the skin subtype most associated with acro-osteolysis. Anti-Topoisomerase I antibody was the Systemic Sclerosis specific antibody most commonly correlated to acroosteolysis. Disease duration, calcinosis and digital ulcers were the most related manifestations, but only the last two were shown to predict acro-osteolysis. Ultrasound showed high sensitivity for diagnosis, but its applicability must be studied. Conclusions: Despite the impact that osteolysis has on individuals with Systemic Sclerosis, there is still an important lack of studies that focus on this topic. The absence of studies focused on the therapeutic approach is noteworthy, as well as the paucity of quality longitudinal studies that allow a reliable assessment of its prognostic value and progression predictors.
Introduction: In Systemic Sclerosis, osteolysis is a potentially disabling musculoskeletal manifestation still poorly studied. Objective: To perform a scoping review focusing on osteolysis in Systemic Sclerosis, in order to summarize knowledge and identify areas that need further investigation. Methods: This review was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews recommendations. Results: 31 articles were included for analysis. The publications included proved to be heterogeneous regarding the population and inclusion criteria. The lack of standardized means for the diagnosis and classification of osteolysis exacerbated these inequalities. Most studies reported locations/prevalence of osteolysis and associations with other manifestations, with only a minority focusing on other topics, especially progression predictors of osteolysis and its prognostic value. None of the authors addressed treatment. The most frequently analyzed and prevalent location was acro-osteolysis. Diffuse Systemic Sclerosis was the skin subtype most associated with acro-osteolysis. Anti-Topoisomerase I antibody was the Systemic Sclerosis specific antibody most commonly correlated to acroosteolysis. Disease duration, calcinosis and digital ulcers were the most related manifestations, but only the last two were shown to predict acro-osteolysis. Ultrasound showed high sensitivity for diagnosis, but its applicability must be studied. Conclusions: Despite the impact that osteolysis has on individuals with Systemic Sclerosis, there is still an important lack of studies that focus on this topic. The absence of studies focused on the therapeutic approach is noteworthy, as well as the paucity of quality longitudinal studies that allow a reliable assessment of its prognostic value and progression predictors.
Description
Keywords
Esclerose Sistémica Osteólise Revisão