Embracing
Totality

IN SYSTEMIC SCLEROSIS

An emerging method helps measure systemic sclerosis in totality

Current measurements, like mRSS, don't capture the totality of systemic sclerosis (SSc), however the paradigm is shifting.1,2

The American College of Rheumatology's provisional Combined Response Index in Systemic Sclerosis (ACR‑CRISS) is an emerging method for evaluating SSc.3

Not an actual patient.

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MONITORING SYSTEMIC SCLEROSIS

Since SSc is complex and heterogeneous, monitoring should take the totality of the disease into account through a multi-system approach that evaluates skin, internal organ, functional, and patient-reported outcomes.3

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ACR-CRISS HELPS PREDICT THE LIKELIHOOD OF IMPROVEMENT

ACR-CRISS is a composite measure that takes into account clinically significant events plus 5 SSc-related domains. It estimates the probability of disease improvement for individuals or in populations relative to baseline status.3

COMPONENTS OF ACR-CRISS

ACR-CRISS takes significant clinical events such as worsening renal or cardiopulmonary involvement into account, as well as evaluates systemic sclerosis across 5 different key domains.3

CLINICALLY SIGNIFICANT CARDIOPULMONARY OR RENAL EVENTS3

NEW ONSET
RENAL CRISIS

NEW ONSET OR
WORSENING OF

LUNG FIBROSIS

NEW ONSET
PULMONARY ARTERIAL
HYPERTENSION

NEW ONSET
LEFT VENTRICULAR
FAILURE

5 KEY DOMAINS OF ACR-CRISS3

Skin Thickening
(mRSS)

Lung Function
(FVC% PREDICTED)

Functional
Disability (HAQ‑DI)

Physician
Global
Assessment

Patient Global
Self‑Assessment

FVC, forced vital capacity; HAQ-DI, Health Assessment Questionnaire Disability Index; mRSS, modified Rodnan skin score.
SSc SNAPSHOT
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UNDERSTANDING GLOBAL ASSESSMENTS

Physician and patient global assessments are unstandardized ratings from 0 to 100. Physicians rate the level of disease activity from a clinical perspective, while patients rate the perceived impact of SSc on their lives in the last week, month, or day since their last visit.4

ACR-CRISS IS AN EMERGING MEASURE IN SYSTEMIC SCLEROSIS

ACR-CRISS has the potential to help improve assessment of emerging therapies in individuals, as well as facilitate the evaluation and comparison across patient populations in clinical trials.3

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The provisional ACR-CRISS score was created by consensus among 40 SSc experts, independently validated in several SSc cohorts, and is now used as an efficacy endpoint in multiple clinical trials in SSc.2,3,5