FRI0341 LOWER URINARY TRACT SYMPTOMS PREVALENCE IN SYSTEMIC SCLEROSIS PATIENTS: RESULTS FROM A COMPREHENSIVE ANALYSIS
Authors: Greta Pacini, Amelia Chiara Trombetta, Federica Goegan, Sabrina Paolino, Carmen Pizzorni, Elisa Alessandri, Massimo Patanè, Emanuele Gotelli, Giorgia Ferrari, Francesco Cattelan, Massimo Ghio, Andrea Casabella, Vanessa Smith, Maurizio Cutolo
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Lower urinary tract symptoms (LUTS) are a seldom-reported manifestation of systemic sclerosis (SSc). Although LUTS have been described in SSc patients with a higher prevalence than in the general population, no controlled studies have been reported to date [1–3]. <h3>Objectives</h3> To compare LUTS prevalence and severity in SSc patients and in healthy subjects and mainly to explore their association with SSc clinical and diagnostic parameters. <h3>Methods</h3> This study evaluated 42 SSc consecutive patients (median age 61 years, range 21-85) and 50 matched healthy subjects (median age 57 years, range 28-93). SSc diagnosis was based on the 2013 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria. LUTS were assessed through validated self-reported questionnaires derived from the International Conference on Incontinence (ICIQ-FLUTS, ICIQ-MLUTS and ICIQ-OAB) [4]. General comorbidities and/or medication potentially related to LUTS, as well as lower urinary tract infections, were evaluated in order to exclude confounding factors. Non-parametric tests and chi-squared test were performed to compare LUTS distribution, namely of urinary incontinence (UI) and overactive bladder (OAB), in the two populations, then linear and logistic regressions were used to test the association between SSc disease and LUTS prevalence and severity. In SSc population, linear and logistic regressions were performed to test the association between LUTS and SSc variables, including nailfold videocapillaroscopy (NVC) patterns ("Early", "Active", "Late"), SSc-related autoantibodies and dual X-ray absorptiometry (DXA) parameters. Multivariate analysis was performed to adjust the associations for potential confounders. A p value &lt; 0.05 and a confidence interval (CI) of 95% were considered statistically significant. <h3>Results</h3> SSc patients showed significantly higher prevalence and severity of UI and OAB than healthy controls (p&lt; 0.005, p&lt; 0.01). SSc was a strong predictor of LUTS, independent of demographic data, comorbidities and treatments (OR 5.57, 95% IC 1.64-18.88). In SSc patients sarcopenia positively correlated with OAB (p&lt; 0.001) and reduced bone mineral density (BMD) positively correlated with OAB (p&lt; 0.05) and UI (p= 0.001). UI positively correlated with anti Scl70 Abs (p&lt; 0.05) and cyclosporine treatment (p= 0.001) and negatively with anti RNA polymerase III Abs (p&lt; 0.05); OAB positively correlated with calcinosis (p&lt; 0.005) and negatively with methotrexate treatment (p&lt; 0.05). NVC "Active" and "Late" patterns were predominant among SSc patients presenting LUTS (both UI and OAB), although not any statistical correlation was found. <h3>Conclusion</h3> For the first time urinary tract involvement was found to be significantly higher in SSc patients than in healthy matched controls. In addition, sarcopenia, bone damage and calcinosis appeared significantly correlated with LUTS, suggesting a possible interplay. <h3>References</h3> [1] John G, et al. Arthritis Care Res. 2018;70:1218–27. [2] Sanchez K, et al. Press Medicale [Internet]. 2016;45(4):e79–89. [3] Adler BL, et al. J Rheumatol. 2018;45:1145–52. [4] Abrams P, et al. J Urol. 2006;175:1063–6. <h3>Disclosure of Interests</h3> None declared