FRI0428 Mean number of capillaries is associated with disease activity at 6 months follow-up in systemic sclerosis patients

Abstract

Background: Nailfold capillaroscopy (NFC) is essential in the evaluation and classification of systemic sclerosis (SSc). The mean number of capillaries is considered a promising tool for assessing vascular involvement in SSc, however there is no consensus yet over how many digits should be analysed and how. Objective(s): Investigation of the associations of the mean number of capillaries, measured by NFC with disease activity (EScSG activity score) and vascular involvement (digital ulcers (DUs) or history of DUs) in a single-centre cohort of patients with SSc. Method(s): 68 patients with SSc fulfilling the ACR/EULAR 2013 classification criteria were included. NFC and extensive assessment per the recommendations of EUSTAR were performed in all patients. 54 patients had a follow-up (FU) at 6 months. 8 digits were examined (II to V of both hands) by NFC; 4 images for each finger were saved. The NFC images were assessed by two experienced raters independently, scoring the mean number of capillaries in all fingers (m-nr/pat), in the 3rd finger of the dominant hand (m-nr/3rd dom) and in the 4th finger of the nondominant hand (m-nr/4th non-dom) for each patient. "Early", 'active' and 'late' Cutolo patterns were also recorded. Result(s): 2176 images were scored at baseline and 1728 at FU. The m-nr/pat at baseline ranged between 3.4-9.1, mean(SD) 5.6 (1.7) for rater 1, respectively 3.3-8.9, 5.2 (1.4) for rater 2. There was good to excellent correlation (Spearman's rho) at baseline and FU of the m-nr/pat with m-nr/3rd dom, m-nr/4th non-dom and Cutolo patterns, and fair correlation of m-nr/3rd dom with m-nr/4th non-dom and Cutolo patterns. We found significant differences of all mean scores of capillaries between patients with and without history of DUs (Mann Whitney U test) (table 1). Using linear regression adjusted for age, gender and history of DUs, mean number of capillaries was associated with disease activity at FU (table 2). Conclusion(s): The mean number of capillaries had a good association with the history of DUs and predicted disease activity at 6 months follow-up. The m-nr/pat performed better in our analysis than the m-nr/3rd dom and m-nr/4th non-dom, however these could be used alternatively in clinical practice as they are less time consuming. (Table Presented).