FRI0434 THE RELATIONSHIP BETWEEN SYMPTOMS OF AUTONOMIC DYSFUNCTION AND CARDIOVASCULAR INVOLVEMENT IN PSORIATIC ARTHRITIS
Authors: Halise Hande Gezer, Didem Erdem, Mehmet Tuncay Duruöz
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The incidence of cardiovascular disease (CVD), diabetes mellitus, metabolic syndrome and subclinical atherosclerosis is markedly increased in patients with psoriatic arthritis (PsA). The autonomic nervous system is the visceral nervous system of the body consisting of two parts; sympathetic and parasympathetic. Patients with PsA have predominantly parasympathetic involvement autonomic nervous system. <h3>Objectives</h3> The aim of this study was to evaluate the symptoms of autonomic dysfunction and their relationship with cardiovascular involvement and other clinic parameters in patients with PsA. <h3>Methods</h3> The study included patients diagnosed with PsA according to the CASPAR criteria. For evaluation of cardiovascular involvement, body mass index (BMI), abdominal obesity, hypertension (HT), diabetes mellitus (DM), hyperlipidemia (HL), metabolic syndrome, fasting glucose levels, lipid levels, systolic and diastolic blood pressures (SBP-DBP) were assessed. DAPSA (Disease Activity in Psoriatic Arthritis), BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), Leeds enthesitis index, Psoriasis Area Severity Index (PASI), Psoriatic Arthritis Quality of Life (PsAQoL) and Health Assessment Questionnaire (HAQ) were used to assess patients clinical situations. The Composite Autonomic Symptom Score (COMPASS-31) (range:0-100) consisting of 6 subdivisions including orthostatic, vasomotor, secretomotor, gastrointestinal (GIS), bladder and pupillomotor was used for the symptoms of autonomic dysfunction. The Mann-Whitney U-test, student's t-test and Spearman's correlation coefficient were used for statistical analysis. P&lt;0.05 was considered statistically significant. <h3>Results</h3> A total of 64 subjects (43 female, 21 male) with a mean of age 49 years (SD:12.3) and disease duration of 59 months (SD:71.3) were recruited into the study. The patients had HT (23.4%), DM (17.2%), abdominal obesity (62.5%), metabolic syndrome (45.3%) and dyslipidemia (42.2%). The mean total COMPASS-31 score was 19.7 (SD:8.3). There was no significant difference in COMPASS-31 scores in patients with or without HT, DM, dyslipidemia. Bladder scores were significantly higher in patients with abdominal obesity and metabolic syndrome (p&lt;0.05). GIS and pupillomotor scores were significantly higher in patients with enthesis (p&lt;0.05). Significant correlations were found between: LDL and bladder (r=0.392) scores; enthesis and GIS (r= 0.303), pupillomotor (r=0.365) scores; DAPSA and total COMPASS-31 (r=0.310), secretomotor (r=0.359) scores; BASDAI and total COMPASS-31 (r=0.483), GIS (r=0.327), secretomotor (r=0.309), pupillomotor (r=0.302) scores; fatigue and total COMPASS-31 (r=0.503), GIS (r=0.377), pupillomotor (r=0.302) scores; HAQ and total COMPASS-31 (r=0.476), orthostatic (r=0.388), bladder (r=0.371) scores; PsAQoL and total COMPASS-31 (r=0.601), orthostatic (r=0.549), secretomotor (r=0.414), pupillomotor (r=0.380) scores. <h3>Conclusion</h3> The total score of COMPASS-31 and its subdivisions were high in PsA patients as compared with literature data on healthy subjects. The symptoms of autonomic dysfunction were increased in PsA patients. Disease activity, functional impairment, fatigue, LDL and quality of life are associated with autonomic dysfunction. Autonomic symptoms improve with disease control. <h3>References</h3> [1] Sletten, D.M., et al., COMPASS 31: a refined and abbreviated Composite Autonomic Symptom Score. Mayo Clinic Proceedings, 2012. 87(12): p.1196-1201. [2] Syngle, A., et al., Autonomic dysfunction in psoriatic arthritis. Clin Rheumatol, 2013. 32(7): p.1059-64. <h3>Disclosure of Interests</h3> Halise Hande Gezer: None declared, Didem Erdem: None declared, Mehmet Tuncay Duruöz Grant/research support from: Abvie, Speakers bureau: Novartis, AMGEN, Abdi İbrahim, İlko