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; Bianca Matthews; Elsa-Lynn Nassar; Marie-Eve Carrier; Linda Kwakkenbos; John D Pauling; Susan J Bartlett; Amy Gietzen; Karen Gottesman; Geneviève Guillot; Marie Hudson; Laura K Hummers; Amanda Lawrie-Jones; Vanessa L Malcarne; Maureen D Mayes; Michelle Richard; Maureen Sauvé; Robyn K Wojeck; Luc Mouthon; Andrea Benedetti; Brett D Thombs; Scleroderma Patient-centered Intervention Network investigators

doi:10.1016/S2665-9913(24)00189-9

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

Lancet Rheumatol. 2024 Oct;6(10):e684-e692. doi: 10.1016/S2665-9913(24)00189-9. Epub 2024 Aug 28.

Authors

Gabrielle Virgili-Gervais¹, Bianca Matthews¹, Elsa-Lynn Nassar², Marie-Eve Carrier¹, Linda Kwakkenbos³, John D Pauling⁴, Susan J Bartlett⁵, Amy Gietzen⁶, Karen Gottesman⁷, Geneviève Guillot⁸, Marie Hudson⁹, Laura K Hummers¹⁰, Amanda Lawrie-Jones¹¹, Vanessa L Malcarne¹², Maureen D Mayes¹³, Michelle Richard¹⁴, Maureen Sauvé¹⁵, Robyn K Wojeck¹⁶, Luc Mouthon¹⁷, Andrea Benedetti¹⁸, Brett D Thombs¹⁹; Scleroderma Patient-centered Intervention Network investigators

Collaborators

Scleroderma Patient-centered Intervention Network investigators:
Catherine Fortuné, Claire E Adams, Richard S Henry, Ghassan El-Baalbaki, Kim Fligelstone, Tracy Frech, Daphna Harel, Monique Hinchcliff, Sindhu R Johnson, Maggie Larche, Catarina Leite, Christelle Nguyen, Karen Nielsen, Janet Pope, François Rannou, Tatiana Sofía Rodriguez-Reyna, Anne A Shouffoer, Maria E Suarez-Almazor, Christian Agard, Laurent Alric, Marc André, Floryan Beaslay, Elana J Bernstein, Sabine Berthier, Lyne Bissonnette, Sophie Blaise, Eva Bories, Alessandra Bruns, Carlotta Cacciatore, Patricia Carreira, Marion Casadevall, Benjamin Chaigne, Lorinda Chung, Benjamin Crichi, Thylbert Deltombe, Christopher Denton, Tannvir Desroche, Robyn Domsic, James V Dunne, Bertrand Dunogue, Regina Fare, Dominique Farge-Bancel, Paul R Fortin, Loraine Gauzère, Anne Gerber, Jessica Gordon, Brigitte Granel-Rey, Aurélien Guffroy, Geneviève Gyger, Erica Hachulla, Sabrina Hoa, Michael Hughes, Alena Ikic, Nader Khalidi, Kimberly Lakin, Marc Lambert, David Launay, Yvonne C Lee, Paul Legendre, Hélène Maillard, Nancy Maltez, Joanne Manning, Isabelle Marie, Maria Martin Lopez, Thierry Martin, Ariel Masetto, Arsène Mekinian, Sheila Melchor Díaz, Morgane Mourguet, Mandana Nikpour, Louis Olgane, Vincent Poindron, Susanna Proudman, Grégory Pugnet, Loïc Raffray, Alexis Régent, Frederic Renou, Sébastien Rivière, David Robinson, Esther Rodríguez Almazar, Sophie Roux, Perrine Smets, Vincent Sobanski, Robert Spiera, Virginia Steen, Evelyn Sutton, Carter Thorne, Damien Vagner, John Varga, Pearce Wilcox, Mara Cañedo Ayala, Vanessa Cook, Cassidy Dal Santo, Tiffany Dal Santo, Monica D'Onofrio, Sophie Hu, Marieke Alexandra Neyer, Sabrina Provencher

Affiliations

¹ Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
² Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada; Department of Psychiatry, McGill University, Montreal, QC, Canada.
³ Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands; Department of IQ Health, Radboud University Medical Center, Nijmegen, Netherlands; Centre for Mindfulness, Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.
⁴ Department of Rheumatology, North Bristol NHS Trust, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
⁵ Department of Medicine, McGill University, Montreal, QC, Canada; Research Institute, McGill University Health Centre, Montreal, QC, Canada; Arthritis Research Canada, Vancouver, BC, Canada.
⁶ National Scleroderma Foundation, Tri-State Chapter, Buffalo, NY, USA.
⁷ National Scleroderma Foundation, Los Angeles, CA, USA.
⁸ Sclérodermie Québec, Longueuil, QC, Canada.
⁹ Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada.
¹⁰ Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, MD, USA.
¹¹ Scleroderma Australia, Melbourne, VIC, Australia; Scleroderma Victoria, Melbourne, VIC, Australia.
¹² Department of Psychology, San Diego State University, San Diego, CA, USA; San Diego State University-University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
¹³ University of Texas McGovern School of Medicine, Houston, TX, USA.
¹⁴ Scleroderma Atlantic, Halifax, NS, Canada.
¹⁵ Scleroderma Society of Ontario, Hamilton, ON, Canada; Scleroderma Canada, Hamilton, ON, Canada.
¹⁶ University of Rhode Island, Kingston, RI, USA.
¹⁷ Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Autoinflammatoires Systémiques Rares d'Ile de France, de l'Est et de l'Ouest, Hôpital Cochin, Paris, France; Assistance Publique Hôpitaux de Paris-Centre, Université Paris Cité, Paris, France.
¹⁸ Department of Medicine, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada; Research Institute, McGill University Health Centre, Montreal, QC, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC, Canada.
¹⁹ Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada; Department of Psychiatry, McGill University, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada; Biomedical Ethics Unit, McGill University, Montreal, QC, Canada; Department of Psychology, McGill University, Montreal, QC, Canada. Electronic address: [email protected].

PMID: 39216493
DOI: 10.1016/S2665-9913(24)00189-9

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.

MeSH terms

Adult
Aged
Cohort Studies
Female
Humans
Male
Middle Aged
Raynaud Disease* / epidemiology
Raynaud Disease* / etiology
Scleroderma, Systemic* / complications
Seasons
Self Report*
Severity of Illness Index*
Temperature