SAT0257 THE SIGNIFICANCE ON THE TRANSITION THROUGH DIFFERENT PATTERNS OF NAILFOLD MICROVASCULAR DAMAGE ON THE COURSE OF SYSTEMIC SCLEROSIS
Authors: Slavica Pavlov-Dolijanovic, Nemanja Damjanov, Nada Vujasinovic Stupar
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Objective</h3> To investigate the timing of transition through different patterns of nailfold microvascular damage in systemic sclerosis (SSc) patients and to determine the significance of this transition. <h3>Methods</h3> In the period January 2012 to December 2017, 400 SSc patients were followed up by nailfold videocapillaroscopy (NVC) the same operator (SPD) every 6 months. Demographic, clinical and laboratory data were recorded. The capillaroscopic findings were classsified as normal, nonspecific or scleroderma pattern ("early", "active", or "late").The evolution on the NVC pattern over time was monitored and recorded. <h3>Results</h3> The transition of microvascular damage through different NVC patterns of microangiopathy was seen in 53/400 (13.25%) SSc patients. At the baseline 11/53 (21%) patients had the non-specific changes, the early pattern had 25/53 (47%) patients, and the active pattern had 17/53 (32%) SSc patients. The mean ± SD time of progression from one to another NVC patterns was 27.68 ± 35.11 months. Improvement of the NVC patterns was found in 15/53 (28%) patients and deterioration in the remaining 38 (72%) patients. The mean time of progression from non-specific to early pattern (in 10 patients) and non-specific to active pattern (in 1 patient) was 14.5 ± 9.73 vs. 12 months, respectively. Time of changed from early to nonspecific (in 7 patients), early to active (in 17 patients) and early to late pattern (in 1 patient) was 30.85 ± 22.56 vs 22.29 ± 16.61 vs 24 months, respectively. Time of changed from active to early (in 8 patients) and active to late pattern (in 9 patients), was 26.25 ± 11.1 vs 18.00 ± 13.97 months, respectively. Progression of non-specific to early or active NVC pattern was related with limited form of SSc (91%), diffuse hand swelling (54%), arthralgia/arthirtis (45%) and involvement of lungs (48%). Also, progression of early to active NVC pattern was related with limited form of SSc (64%), sclerodactyly (48%) and involvement of lungs (48%). In contrast, progression of active to late NVC pattern was related with diffuse form of SSc (53%), digital ulcerations (35%) and more frequent involvement of lungs (65%). These differences in the frequency of involvement of certain organs were not statistically significant. <h3>Conclusion</h3> These results demonstrate dynamic transition of microvascular damage through different NVC patterns of microangiopathy in about 13% of SSc patients. Patients with rapid progression from the early to active, as well as active to the late NVC patterns (&lt;2 years) should be monitored closely, because they are at risk of further significant damage to the internal organs. <h3>Disclosure of Interests</h3> Slavica Pavlov-Dolijanovic: None declared, Nemanja Damjanov Grant/research support from: AbbVie, Pfizer and Roche, Consultant for: Abbvie, Gedeon Richter, Merck, Novartis, Pfizer and Roche., Speakers bureau: Abbvie, Gedeon Richter, Merck, Novartis, Pfizer and Roche., Nada Vujasinovic Stupar: None declared