LAUSR

Background Several studies demonstrated the relationship between blood perfusion (BP), dermal thickness (DT) and nailfold microangiopathy (“Early”, “Active” and “Late” videocapillaroscopic patterns) in patients with systemic sclerosis (SSc).1–3 Objectives The aim of this study was to evaluate the changes of BP and DT, during a follow-up of 5 years, in SSc patients with persistent “Late” NVC pattern at baseline, as well as to confirm the correlations among microvascular damage extent, absolute nailfold capillary number (CN), BP and DT, during the follow-up. Methods Twenty-three female patients affected by SSc according to the LeRoy criteria4 (mean age 63±4 SD years, mean disease duration 6±4 years), displaying the most advanced “Late” NVC pattern of microangiopathy at baseline (T0), were enrolled and followed for five years (T5), after informed consent. Laser speckled contrast analysis (LASCA), skin high frequency ultrasound (US), modified Rodnan skin score (mRSS), and nailfold videocapillaroscopy (NVC) were yearly performed. Blood perfusion (BP), assessed by LASCA at the level of fingertips, periungual areas, dorsum and palm of both hands, was calculated as perfusion units (PU).1–3 Dermal thickness (DT) was assessed by both US and mRSS in the same above reported areas.5 The microangiopathy evolution score (MES) and the CN per linear millimetre at first distal row were evaluated by NVC.6,7 Patients were receiving a wide range of drugs, including vasodilators, immunosuppressive agents and endothelin receptor antagonists. Statistical analysis was performed by non parametric tests. Results A progressive statistically significant decrease of both BP (p<0.0001) and nailfold CN (p<0.0001) values was observed from T0 to T5 at the level of all areas, as well as a progressive statistically significant increase of DT (p<0.0001), mRSS (p<0.0001) and MES (p=0.01) values. The progressive decrease of BP positively correlated over time with the worsening of nailfold CN (p=0.03, r=0.62), MES (p=0.05, r=0.62), mRSS (p=0.002, r=0.72) and DT (p=0.002, r=0.64). Conclusions Microvascular damage with progressive reduction of nailfold capillary number was found, in a five-year follow-up, associated with progressive functional microvascular damage and DT worsening in the present cohort of SSc patients showing a persistent “Late” NVC pattern. References [1] Ruaro B, et al. Ann Rheum Dis2014;73:1181–5. [2] Sulli A, et al. Ann Rheum Dis2014;73:247–51. [3] Ruaro B, et al. Microvasc Res2017;115:28–33. [4] LeRoy EC, et al. J Rheumatol2001;28:1573–1576. [5] Sulli A.,et al. Arthritis Research & Therapy2017;19:61. [6] Cutolo M, et al. Rheumatology2004; 43:719–26. [7] Sulli A, et al. Ann Rheum Dis2008;67:885–7. Disclosure of Interest None declared