AB1228 TIME LAG FROM THE ONSET OF RAYNAUD’S PHENOMENON TO SYSTEMIC MANIFESTATIONS IN SYSTEMIC SCLEROSIS PATIENTS OF A RACIALLY DIVERSE POPULATION
Authors: H. Weisleder, N. Patel, A. Ramu, D. Chen, P. Friedmann, A. Mansour, M. Parmar, B. Ayesha
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic Sclerosis (SSc) is an autoimmune disease characterized by vasculopathy and organ fibrosis leading to visceral damage. It is further classified as limited or diffuse SSc based on cutaneous involvement. Both limited and diffuse SSc are associated with systemic manifestations, such as gastroesophageal reflux disease (GERD) and interstitial lung disease (ILD). Raynaud phenomenon (RP) is seen in the majority of SSc patients and can precede systemic manifestations by years. There is limited literature on how this disease affects minority populations. <h3>Objectives:</h3> We aimed to compare the time lag from the onset of RP to systemic manifestations in patients with SSc in a racially diverse population. <h3>Methods:</h3> After institutional review board (IRB) approval, we queried electronic medical records at our institution between 1990-2021 identifying patients with SSc. Patients ≥ 18 years of age who met 2013 ACR classification criteria for systemic sclerosis were included. Clinical, laboratory and imaging data were extracted by retrospective chart review. Systemic manifestations of SSc were defined as instances of GERD and ILD. Time between the onset of RP and the onset of systemic manifestations was compared between limited and diffuse SSc patients. Statistical analysis was performed using two-sample t-test for continuous and fisher's exact test for categorical variables. <h3>Results:</h3> A total of 189 patients were identified with SSc; of those, 76 patients met criteria for inclusion. In our cohort, 61 (80%) patients had limited SSc and 15 (20%) had diffuse SSc. Of those with limited SSc, 42 (69%) were Hispanic, 12 (20)% were Black, 5 (8%) were Caucasian, and 2 (3%) were Asian; mean age at diagnosis was 53 years and 55 (90%) were female. Of those with diffuse SSc, 7 (46%) were Hispanic, 6 (40%) were Black, 1 (7%) was Caucasian, and 1 (7%) was Asian; mean age at diagnosis was 43 years, and 12 (80%) were female. GERD was seen in 60 (98%) of limited SSc and 15 (100%) of diffuse SSc. ILD was seen in 15 (20%) of limited SSc and 8 (53%) of diffuse SSc. In limited SSc it took 246 days from the onset of RP to disease diagnosis, 905 days from RP to GERD symptoms, and 1774 days from RP to ILD diagnosis. In diffuse SSc, it took 353 days from the onset of RP to disease diagnosis, 528 days from RP to GERD symptoms, and 1558 days from RP to ILD diagnosis. When comparing time from RP onset to diagnosis of ILD in limited versus diffuse SSc, the difference was not statistically significant. <h3>Conclusion:</h3> Our racially diverse cohort highlighted the disease manifestations of a largely Hispanic and female population of SSc patients. On average, it took longer for patients with limited SSc to develop systemic manifestations than diffuse SSc, which is consistent with current trends. Interestingly, it took a similar amount of time to diagnose ILD in both populations, compared with current trends of earlier ILD diagnosis in diffuse SSc. Social determinants of health may have played a role in timing of disease diagnosis, particularly in our minority population. Our study reinforces the vast disease spectrum that exists for SSc patients, underscores the burden of systemic disease manifestations, and emphasizes the importance of early screening for systemic manifestations in these patients to reduce morbidity and mortality. <h3>REFERENCES:</h3> [1] Adigun R, Goyal A, Hariz A. Systemic Sclerosis. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430875/ <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>