SAT0406 THE ASSOCIATION BETWEEN PERIPHERAL ENTHESITIS SCORES AND NAILFOLD VIDEOCAPILLAROSCOPY FINDINGS IN PATIENTS WITH PSORIATIC ARTHRITIS
Authors: P. Bora Karsli, N. Guven, I. Sunar, Ş. Ataman
Journal: Annals of the Rheumatic Diseases (2020)

Background: Enthesitis is one of the key feature of psoriatic arthritis (PsA), it is usually overlooked in the asymptomatic patients. Nail disease often precedes PsA and nailfold videocapillaroscopy (NVC) is a useful technique for evaluating changes in microcirculation of nail that is considered to play an important role for early detection of enthesitis and PsA [1-4]. Objectives: To investigate the link between NVC findings and severity of peripheral enthesitis scores in patients with PsA. Methods: In this cross-sectional single center study, 34 consecutive PsA patients and as control group (healthy controls - HC), 22 subjects without rheumatic diseases were involved. Psoriasis area severity index (PASI) was used to express severity of psoriasis (Ps) and percentage of affected area. Leeds enthesitis index (LEI) comprised assesment of lateral epicondyles of humerus, medial condyles of femur, and the insertion of the Achilles tendon. Madrid Sonographic Enthesitis Index (MASEI) was applied to quantify the extent of sonographic entheseal abnormalities. MASEI-inflammatory, MASEI-damage and as a sum of these MASEI-total scores were recorded. NVC was performed on eight fingers in each subject. Results: We enrolled 34 patients with PsA (median age=47.74 years, median disease duration=6.91 years) and 22 HC (median age=46.77 years). There were no significant differences between two groups concerning age, gender distribution and body mass index. Ps and PsA disease duration in terms of years were not correlated with MASEI and NVC scores. PASI score associated with MASEI-inflammatory score (r=0.40, p=0.01). There were significant correlation between the NVC score and MASEI-inflammatory (r=0.53, p=0.001) and MASEI-total scores (r=0.35, p=0.04) (Table 1). No association was found between LEI and NVC scores (p=0.34). MASEI enthesitis and NVC scores were significantly higher in the patient group (p=0.00). Table 1. Correlation between the capillaroscopy findings and MASEI- inflammatory and MASEI-total scores in patients with psoriatic arthritis MASEI Capillaroscopy PsA HC MASEI-inflammatory r 0.53** 0.7 p 0.001 0.75 MASEI-total r 0.35* 0.19 p 0.04 0.38 Spearman’s Correlation Coefficient; ** Correlation is significant at the 0.01 level (2-tailed), * Correlation is significant at the 0.05 level (2-tailed). p&lt; 0.05 statistic significance MASEI: Madrid Sonographic Enthesitis Index, PsA: psoriatic arthritis, HC: healthy controls Conclusion: NVC may objectively reflect the peripheric enthesopathy severity and give opportunity for early diagnosis of PsA. References: [1]Kaeley, Gurjit S., et al. “Enthesitis: a hallmark of psoriatic arthritis.” Seminars in arthritis and rheumatism. Vol. 48. No. 1. WB Saunders, 2018. [2]Ash, Zoe R., et al. “Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails.” Annals of the Rheumatic Diseases 71.4 (2012): 553-556. [3]Smith, Vanessa, et al. “Nailfold capillaroscopy and clinical applications in systemic sclerosis.” Microcirculation 23.5 (2016): 364-372. [4]Ribeiro, Camila Ferrari, et al. “Periungual capillaroscopy in psoriasis.” Anais brasileiros de dermatologia 87.4 (2012): 550-553. Disclosure of Interests: None declared