Becker M, et al. - Through 1,451 patients with systemic sclerosis (SSc, a rheumatic disease characterized by autoimmunity, tissue fibrosis, and vasculopathy, and which has a high mortality rate in comparison to other rheumatic diseases) recruited in a European Scleroderma Trials and Research analysis, the researchers recognized factors that allowed enrichment of patients with mortality and worsening of organ function as endpoints. Age, active digital ulcer (DU), lung fibrosis, muscle weakness, and elevated C-reactive protein (CRP) level were strongly correlated to disease progression. Also, an association between active DU, CRP elevation, lung fibrosis, and muscle weakness with a significantly shorter time to disease progression was recognized. Successful confirmation of the model was exhibited by a bootstrap validation step with 10,000 repetitions. Hence, in patients at risk for overall disease worsening in SSc clinical trials, such predictive factors could facilitate cohort enrichment. Also, the role of CRP elevation as a sign of active disease with its potential importance as an inclusion criterion in trials was observed.