AB0455 MODIFICATION OF PROGNOSIS INTERVALS WAS DERIVED BY THE DISCRIMINATION FUNCTION FOR SSc-ILD PATIENTS
Authors: O. Ovsyannikova, L. P. Ananyeva, L. Garzanova, O. Koneva, S. Glukhova, M. Starovoytova, O. Desinova, R. Shayakhmetova
Journal: Annals of the Rheumatic Diseases (2021)

Background: Systemic sclerosis (SSc) is a multisystem autoimmune disease. Pulmonary alterations are the major cause of mortality in SSc. SSc-ILD has heterogeneous disease progression: many patients will have a chronic, indolent course while others may develop progressive, life-threatening disease. Objectives: To assess prognosis intervals for pts with SSc-ILD. Methods: It was a longitudinal study involving 140 pts with SSc-ILD. The mean age was 46.7±13.9years, females 82%, SSc duration 6.2±5.8 years, diffuse subset - 54%. The mean duration of follow up was 73,2±27,8 months. Clinical, laboratory, and immunologic data were collected on all patients. Based on analysis of discrimination function the equation of prognosis was developed. The equation is 3.14GGO (ground glass opacities) + 0,7 index EScSG – 1,326 FVC - 0,1 the maximum daily dose of glucocorticoids + 0,136 Gamma globulins + 1.066 CYP – 1.075 DLCO ≤ 5,8. Value of equation of prognosis to 5.8 corresponds to stabilization or good prognosis and value after 5.8 corresponds to poor prognosis. The equation of prognosis had 86% sensitivity and 56% specificity. The cut-off point 4.7 was represented 65% sensitivity and 67% specificity. The prognosis intervals were following: value of equation to 4.7 corresponds to good prognosis; value from 4.8 to 5.8 corresponds to stabilization and value after 5.8 corresponds to poor prognosis. Results: Pts were distributed into groups depending on results of discrimination function: 14 pts (10%) - zone of good prognosis; 8 pts (6%) - zone of stabilization and 118 (84%) - zone of poor prognosis. We have decided to join pts from zone good prognosis and zone stabilization into united group (U-group) - 22 pts (16 %). Table 1. Comparative characteristics of the groups Parameters Group 1 (n=14) Group 2 (n=8) U-Group (n=22) Group 3 (n=118) Age years 45,4±16,4 50,2±15,8 47,2±16 47,5±13 P&gt;0,05 Gender Male 3(21%) 1(12,5%) 4(18%) 21(18%) Female 11(79%) 7(87,5%) 18(82%) 97(82%) P&gt;0,05 Limited form 8(57%) 2(35%) 10(46%) 54(46%) Diffuse form 6(43%) 6(75%) 12(54%) 64(54%) P&gt;0,05 Duration of disease years 6,8±7,6 5±4,2 6,2±6,4 6,5±5,7 p&gt;0,05 CRP mg/ml 10±10 8,5±10,6 9,4±10,4 12,6±23,9 p&gt;0,05 ESR mm/h 16,7±13,1 17,4±21,9 17±16,3 23,5±16,7 p&gt;0,05 ANA-hep-2 525±322* 420±190 487±281* 774±430* p: Gr1 vs Gr3 =0,038; Gr2 vs Gr3=0,02; Gr1,2 vs Gr3 =0,032 a-Scl-70 u/ml 59,9±82,7* 67±94,5 116±93** 62,5±85* ** p: Gr1 vs Gr3 =0,03; Gr1,2 vs Gr3 =0,013 Ejection fraction(EF)(%) 67,3±5,3* 65,5±6,1 66,7±5,5** 63±6,8* ** p: Gr1 vs Gr3 =0,02; Gr1,2 vs Gr3 =0,017 PAP mm hg 31,6±5,8 32,4±9,3 31,9±7 36,4±14 p&gt;0,05 6MWT m (6 Minute walk test) 490±110 477±104 485±104 430±100 p&gt;0,05 The age, SSc duration, gender proportion and SSc forms, were similar in the all groups (p&gt;0,05). In the study mean dates of ANF-hep-2, a-Scl-70 were significantly lower and EF was significantly higher in groups 1 and U-group than in group 3. In groups 1,2 and U-group the mean levels of ESR, CRP, PAP were lower and value of 6MWT were higher than mean levels in group 3 accordingly. So separately group 2 didn’t have significant differences with group 1 and 3. Conclusion: In the study we didn’t find any correlation between meanings of group 2 and groups 1,3 but the meanings of group 1 and U-group have had the same correlation. It would be rational to highlight only one zone of prognosis before and after 5,8. Disclosure of Interests: None declared.