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Correspondence response
Response to: ‘Will SPAR be useful in the usual patients with scleroderma?’ by Chattopadhyay et al
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  1. Wanlong Wu1,2,
  2. Suzana Jordan1,
  3. Oliver Distler1
  1. 1 Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
  2. 2 Department of Rheumatology, South Campus, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
  1. Correspondence to Dr Oliver Distler, Department of Rheumatology, University Hospital Zurich, Zürich 8091, Switzerland; oliver.distler{at}usz.ch

https://doi.org/10.1136/annrheumdis-2018-214270

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    Thank you very much for your interest in our article ‘Prediction of progression of interstitial lung disease in patients with systemic sclerosis: the SPAR model’1 and your precious questions ‘Will SPAR be useful in the usual scleroderma patients?’.2 We are glad to respond as below.

    External validity of the Study cohort

    The external validity of the patients recruited is unclear. The authors may like to provide their cohort numbers and how many of them fulfilled the inclusion criteria.

    Regarding the question on the external validity of the study cohort, we would like to stress that our study cohort focused on patients with mild interstitial lung disease (ILD) on high resolution computer tompgraph (HRCT), without defining a limit for forced vital capacity (FVC). That is the reason why our patients had an average normal FVC. We disagree that patients with milder ILD and normal FVC are uncommon in clinical practice—please see our recent study.3 In fact, many patients with (milder) ILD might be missed if only lung function testing is used for screening.

    However, we agree that these patients have not been included in recent interventional clinical trials such as scleroderma lung study …

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