AB0453 THE CHARACTERISTICS OF SSc-ILD PATIENTS WITH ACTIVE THERAPY IN DIFFERENT PROGNOSIS INTERVALS BASED ON DISCRIMINANT ANALYSIS
Authors: O. Ovsyannikova, L. Garzanova, L. P. Ananyeva, O. Koneva, S. Glukhova, O. Desinova, M. Starovoytova, R. Shayakhmetova
Journal: Annals of the Rheumatic Diseases (2021)

Background: Interstitial lung disease (ILD) frequently complicates SSc and can be a debilitating disorder with a poor prognosis. Several risk factors for progressive SSc-ILD have been identified and prognostic scoring systems have identified predictors of mortality. It’s important to develop treatment recommendation. Objectives: To use the discrimination function for pts with SSc-ILD and highlight pts with different prognosis. Methods: It was a longitudinal study involving 140pts with SSc-ILD. The mean age was 46.7±13.9ys, females 82%, SSc duration 6.2±5.8ys, diff subset-54%. The mean duration of follow up was 73,2±27,8months. All pts received low- and moderate-dose glucocorticoids (Gc), RTM (the mean dose 3,14±2,38g) and 77 pts had received parenteral CyP(mean dose 15,9±15,6g). We have got the discrimination function that included: ground glass opacities (GGO)(1–the absents of GGO; 2–the presents of GGO); index EScSG(the digital value); FVC(FVC≥75=0, FVC&lt;75=1); the maximum daily dose of Gc (the digital value,mg); Gamma globulins (the digital value,%); cyclophosphamide (CYC) (the absence of CyP=0, the treatment of CYC =1);DLco(DLco&lt;52% =0, DLco≥52=1). We assessed all parameters at the entry in the study except DLco evaluated after one year of follow up. Based on this analysis the equation was developed. The equation of prognosis is 3.14GGO+0,70index EScSG–1,326 FVC-0,1 the maximum daily dose of glucocorticoids+0,136 Gamma globulins+1.066 CYP–1.075DLCO≤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. Results: Оn results of discrimination function pts were distributed in the following order: 22 pts(16%) were into zone of stabilization(Group 1) and 118(84%) - in zone of poor prognosis, among which 13pts died during the study. That`s why pts in zone of poor prognosis were divided into group 2 - survived pts (n=105(75%)) and group 3– died pts(n=13 (9%)).So we have got 3groups; the age, SSc duration, gender proportion and SSc forms, were similar in the all groups(p&gt;0,05). Table 1. Baseline characteristics of the groups Parameters Group 1 (n=22) M±SD Group 2 (n=105) M±SD Group 3 (n=13) M±SD CRP mg/ml 9,4±10,4 11,5±23,4 21,5±27,1 ME [25‰/75‰] 7,5 [1,9;11,2] 5 [1,6;10,4] 9,9 [5;32,8] ESR mm/h 17±16,35 23,6±17 22,9±14,3 a-Scl-70 u/ml 62,5±85* 118,6±93,09* 102,1±96 Skin score 9,63±7,7 11,5±9,9 9±9,23 Index EScSG 1,9±1,7** 3,4±1,9** 2,9±1,1 Mean PAP mm hg 31,9 ±7β ββ 35±11,9 β 47,5±23,3ββ Cumulative dose of CyP g 1,5±3γ γγ 11,4±14,4γ 18,9±23,3γγ ME [25‰/75‰] 0 [0;2] 4,9 [0;17] 4 [0;46,5] Сumulative dose of RTM, g 3,15±1,6 2,63±1,36 2,2±1,5 * - p=0,01; **p=0,0008; β - p=0,006; ββ - p=0,03; γ- p=0,002; γγ - p=0,0018 Mean level a-Scl-70, Index EScSG were significantly lower in group 1 vs group 2. Mean value of PAP and dose of CyP were significantly increased in group 3. It should be noted that pts with good prognosis have had low level of all parameters and high dose of RTM. Conclusion: The discrimination function is a proposed screening algorithm for pts with SSc-ILD who could develop progression disease. Usage of discrimination function revealed that 84% pts with ILD-SSc have got poor prognosis and 9% of them have got fatal outcome. Usage the equation of prognosis is very useful to choice of treatment and observation pts SSc-ILD. Disclosure of Interests: None declared.