THU0278 NAILFOLD CAPILLAROSCOPY IN SJÖGREN’S SYNDROME: A SYSTEMATIC LITERATURE REVIEW AND STANDARDISED INTERPRETATION
Authors: K. Melsens, M. C. Leone, S. Paolino, M. Cutolo, D. Elewaut, R. Gerli, I. Peene, V. Smith
Journal: Annals of the Rheumatic Diseases (2020)

Background: Sjögren Syndrome (SS) is a rheumatic connective tissue disease in which vascular involvement (e.g. Raynaud’s phenomenon) may occur. No systematic review exists elucidating on the role of nailfold capillaroscopy in SS. Objectives: To give a standardised overview of capillaroscopic changes and clinical associations in SS. Methods: The literature was searched through in three databases by two reviewers. All published original studies which assess patients with SS by capillaroscopy were revised. A quality assessment was applied, based on sample size, population description, presence of a control group, presence of instrumental specifications and/or standardly applied capillaroscopic methodology, presence of clear descriptions of capillaroscopic parameters and based on the used statistical analysis. The capillaroscopic findings were described in a EULAR consented standardised way (1). Significant associations of capillaroscopic parameters in SS-patients with clinical and laboratory variables were also reported. Results: The literature search resulted in 826 hits. Based on title and abstract screening 519 original studies were retained and of these, 12 full texts described an assessment by nailfold capillaroscopy in SS. Six studies (four case-control studies and two case-series) were retained after performing a critical quality assessment (fig 1). EULAR standardised description (table 1) attested conclusive results for capillary ‘morphology’, suggesting a not higher prevalence of abnormal shapes in SS than in healthy (2,3). Concerning clinical associations, capillary density was associated with Raynaud in two studies and with interstitial lung disease in one study (2-4). No association between serologic features (anti-nuclear antibodies, anti-SSA, anti-SSB and anti-RF) and capillaroscopic parameters were found (2,5). Table 1. Standardised description of capillaroscopic characteristics in Sjögren’s Syndrome vs Healthy Legend. Only studies mentioning p-values were considered in this table. *Tektonidou et al. did not report differences between healthy controls and the SS group as a whole, but rather reported differences between healthy controls and subgroups of patients with/without Raynaud’s and with/without centromere antibodies. Assessment Parameter Significant Not significant Conclusion Quantitative Density 1 study [2] 1 study [3] Not conclusive Dimension Dilation Giant 0 studies 0 studies 0 studies 1 study [2] Not conclusive Normal morphology Hairpin shaped Tortuosity Crossing 0 studies 0 studies 0 studies 0 studies 1 study [3] 1 study [3] Not conclusive Abnormal morphology 0 studies 2 studies [2,3] Equal absence of abnormal morphology in SS vs healthy controls Haemorrhages 0 studies 2 studies [2,3] Not conclusive* Semi quantitative 0 studies 0 studies No data Qualitative Normal Non specific abnormalities Scleroderma pattern 0 studies 0 studies 0 studies 1 study [3] 1 study [3] 0 studies Not conclusive* Not conclusive* No data Conclusion: A small number of studies have investigated the role of nailfold capillaroscopy in SS. Prospective follow up studies with standard evaluation and capillaroscopy in SS are warranted. References: [1]Smith et al Autoimmun Rev 2020, DOI: 10.1016/j.autrev.2020.102458 [2]Capobianco et al Clin Exp Rheumatol 2005;23(6):789-94 [3]Tektonidou et al Rheumatology (Oxford, England) 1999;38(9):826-30 [4]Cakmakci et al Tuberk Torakx 2015;63:22-30 [5]Corominas et al Rheumatol Int 2016;36(3):365-9 Disclosure of Interests: Karin Melsens: None declared, Maria C. Leone: None declared, Sabrina Paolino: None declared, Maurizio Cutolo Grant/research support from: Bristol-Myers Squibb, Actelion, Celgene, Consultant of: Bristol-Myers Squibb, Speakers bureau: Sigma-Alpha, Dirk Elewaut: None declared, Roberto Gerli: None declared, Isabelle Peene: None declared, Vanessa Smith Grant/research support from: The affiliated company received grants from Research Foundation - Flanders (FWO), Belgian Fund for Scientific Research in Rheumatic diseases (FWRO), Boehringer Ingelheim Pharma GmbH &amp; Co and Janssen-Cilag NV, Consultant of: Boehringer-Ingelheim Pharma GmbH &amp; Co, Speakers bureau: Actelion Pharmaceuticals Ltd, Boehringer-Ingelheim Pharma GmbH &amp; Co and UCB Biopharma Sprl