The association of outdoor temperature and self-reported Raynaud's phenomenon severity among people with systemic sclerosis: a Scleroderma Patient-centered Intervention Network Cohort study
Gabrielle Virgili-Gervais MSc , Bianca Matthews BSc , Elsa-Lynn Nassar MSc , Marie-Eve Carrier MSc , Linda Kwakkenbos PhD , John D Pauling MD , Prof Susan J Bartlett PhD , Amy Gietzen , Karen Gottesman BA , Geneviève Guillot PDt , Marie Hudson MD , Laura K Hummers MD , Amanda Lawrie-Jones , Prof Vanessa L Malcarne PhD , Prof Maureen D Mayes MD , Michelle Richard DSW , Maureen Sauvé BA , Robyn K Wojeck PhD , Prof Luc Mouthon MD , Andrea Benedetti PhD , Sabrina Provencher
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引用次数: 0
Abstract
Background
Raynaud's phenomenon is the earliest and most common systemic sclerosis manifestation. Episodes can be triggered by cold exposure and ambient temperature changes. Small studies have found that Raynaud's phenomenon outcomes were associated with season. We aimed to map the degree that differences in ambient temperature are associated with Raynaud's phenomenon outcomes across the temperature spectrum.
Methods
People with Raynaud's phenomenon secondary to systemic sclerosis in the Scleroderma Patient-centered Intervention Network Cohort completed past-week Raynaud's phenomenon severity assessments (0–10 numerical rating scale) at enrolment and longitudinally at 3-month intervals. Mean daily temperature and feels like temperature, which incorporates wind chill and humidity, for the week before each assessment were extracted for each participant from a weather site close to the participant's recruiting centre via the Iowa Environmental Mesonet. We used linear mixed models with basis splines to flexibly model non-linear changes in Raynaud's phenomenon severity across the temperature spectrum. People with lived experience of systemic sclerosis contributed to the study design and interpretation.
Findings
Between April 15, 2014 and Aug 1, 2023, we included data on 20 233 Raynaud's phenomenon severity assessments from 2243 participants. 1964 (88%) of 2243 participants were women, 279 (12%) were men, and 1813 (82%) were White. Mean age was 54·8 (SD 12·7) years. The maximum predicted Raynaud's phenomenon severity score was 6·8 points (95% CI 5·6–8·1), which occurred at –25°C. Severity scores decreased minimally from –15°C to 5°C (0·05–0·21 points per 5°C difference), then decreased in larger steps between 5°C and 25°C (0·37–0·54 points per 5°C difference). The minimum predicted score was at 25°C (2·6 points [95% CI 2·5–2·7]). Scores increased at temperatures above 25°C to 3·5 points (3·0–4·1) at 35°C and 5·6 points (4·5–6·8) at 40°C. Results were similar for feels like temperature.
Interpretation
Raynaud's phenomenon severity is worst at very cold temperatures but also increases with very warm temperatures, presumably due to air conditioning. Clinical management and Raynaud's phenomenon intervention trial designs should consider temperature patterns.
Funding
Scleroderma Society of Ontario, Scleroderma Canada, Sclérodermie Québec, Scleroderma Manitoba, Scleroderma Atlantic, Scleroderma Association of BC, Scleroderma SASK, Scleroderma Australia, Scleroderma New South Wales, Scleroderma Victoria, the Canadian Institutes of Health Research, the Arthritis Society, the Lady Davis Institute for Medical Research of the Jewish General Hospital, the Jewish General Hospital Foundation, and McGill University.
期刊介绍:
The Lancet Rheumatology, an independent journal, is dedicated to publishing content relevant to rheumatology specialists worldwide. It focuses on studies that advance clinical practice, challenge existing norms, and advocate for changes in health policy. The journal covers clinical research, particularly clinical trials, expert reviews, and thought-provoking commentary on the diagnosis, classification, management, and prevention of rheumatic diseases, including arthritis, musculoskeletal disorders, connective tissue diseases, and immune system disorders. Additionally, it publishes high-quality translational studies supported by robust clinical data, prioritizing those that identify potential new therapeutic targets, advance precision medicine efforts, or directly contribute to future clinical trials.
With its strong clinical orientation, The Lancet Rheumatology serves as an independent voice for the rheumatology community, advocating strongly for the enhancement of patients' lives affected by rheumatic diseases worldwide.