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Impact of Capillaroscopy on the Management of Undifferentiated Connective Tissue Disease

Undifferentiated Connective Tissue Diseases

Connective tissue diseases (CTD) are a group of diseases with diverse manifestations, most often multisystemic, which share an autoimmune etiology. They include Systemic lupus erythematosus (SLE), Systemic sclerosis (SSc), Sjögren's syndrome (SS), Inflammatory myopathies (IM) and Mixed connective tissue disease (MCTD).

Many patients in rheumatology present signs and symptoms of CTD, but without meeting all the classification criteria for one of these diseases. These patients will generally receive a diagnosis of undifferentiated connective tissue disease (UCTD). It is increasingly suggested that there are two subgroups of patients with UCTD: one which will eventually evolve into a better characterized CTD (approximately 30% of patients at 5 years) and another with a more benign prognosis. The optimal management of patients with UCTD is not clearly established.

Capillaroscopy is a diagnostic test used in the investigation of patients with CTD. It is a low-cost, non-invasive, rapid and specific test in the evaluation of this class of diseases. Its role is now well established in the diagnosis of SSc and in the investigation of Raynaud's phenomenon. In addition, capillaroscopy helps to identify patients suffering from CTD more quickly.

Knowledge about the role of capillaroscopy in UCTD is more limited. It is established that a significant proportion of patients with UCTD present abnormalities on UCTD present non-specific abnormalities and 11% present a scleroderma pattern. In these patients, abnormal capillaroscopy seems to increase the risk of progressing to a better characterized CTD, notably SSc.

However, although capillaroscopy is increasingly used in rheumatology in patients with CTD, more research is needed to clarify the role of this examination in UCTD. First, it is not established whether capillaroscopy should be performed in all patients with UCTD, nor when exactly it should be performed. There also remain questions about the impact of capillaroscopy on the prognosis and management of patients with this disease. To our knowledge, there is no prospective study that has addressed this question. The investigators hypothesize that in patients with UCTD, capillaroscopy compared to usual care makes it possible to increase the proportion of patients obtaining a diagnosis of better characterized CTD in the first six months of follow-up.

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Participation Requirements

  • Sex:

    ALL

  • Eligible Ages:

    18 and up

Participation Criteria

Inclusion Criteria:

* Be aged 18 and over;
* Have been diagnosed with undifferentiated connective tissue disease by a rheumatologist;
* Meet the preliminary classification criteria for undifferentiated connective tissue disease: present signs and symptoms suggestive of connective tissue disease, but do not meet the criteria for a connective tissue disease and have a positive antinuclear antibody on at least 2 occasions;
* Have developed the first signs and symptoms of the disease less than 10 years before recruitment.

Exclusion Criteria:

* In the opinion of the clinician, have a health condition that does not allow a delay of six months before carrying out the capillaroscopy;
* Have been diagnosed and/or meet the classification criteria for another connective tissue disease (for example, systemic lupus, etc.);
* Have already performed a capillaroscopy in the past, regardless of the time or the reason;
* Be unable to consent or respond to questionnaires.

Study Location

CHU de Quebec-Université Laval
CHU de Quebec-Université Laval
Québec, Quebec
Canada

Contact Study Team

Primary Contact

Laetitia Michou, MD PhD

[email protected]
418 525 4444
Backup Contact

William Berthelot, MD

[email protected]
418 654 2242
Study Sponsored By
CHU de Quebec-Universite Laval
Participants Required
More Information
Study ID: NCT06399822