POS1416 ROLE OF ANTI-RO52/SSA IN GASTROINTESTINAL MANIFESTATIONS OF SYSTEMIC SCLEROSIS PATIENTS
Authors: R. Ugena-García, C. Calomarde-Gómez, N. Viveros, F. Salabert-Carreras, C. Rocamora-Gisbert, A. Nack, Á. Prior-Español, S. Holgado Pérez, L. Mateo-Soria, A. Riveros-Frutos, J. Font-Urgelles, I. Casafont-Solé
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Gastrointestinal dysmotility (GID) is one of the most prevalent organ involvement manifestations in systemic sclerosis (SSc). It can manifest with very heterogeneous symptoms that vary from upper tract manifestations such as gastroesophageal reflux (GER) and dysphagia) to intestinal disorders like small intestine bacterial overgrowth (SIBO) or intestinal pseudo-obstruction. To date, some studies have tried to elucidate the role of anti-Ro52/SSA antibodies in clinical manifestations in SSc such as interstitial lung disease (ILD). However, its role in other clinical manifestations such as gastrointestinal dysmotility remains uncertain. <h3>Objectives:</h3> To determine if there is an association between GID and the positivity of anti-Ro52/SSA antibodies in patients with SSc. As a secondary endpoint: to describe the gastrointestinal tract symptoms and complications, and to determine if there are differences between anti-Ro52 seropositive and negative patients. <h3>Methods:</h3> Retrospective cross-sectional observational study. Adult patients diagnosed with SSc (meeting EULAR/ACR 2013 classification criteria) under follow-up at a tertiary hospital in Spain between January 2005 and December 2023 were included. GID was assessed using a videofluoroscopic swallowing study (VFSS), an esophageal manometry (EM) or anorectal manometry (ARM). A patient was considered to have GID if any of these tests were positive. Anti-Ro52/SSA serological status and clinical and demographic data were also recorded from medical history. Patients without GID or anti-Ro/SSA available data were excluded. <h3>Results:</h3> A total of 95 patients were included, their clinical and demographic characteristics displayed in Table 1. There were no relationships found in any SSc organ involvement between groups. Gastrointestinal (GI) clinical manifestations are shown in Table 2. Of all patients, 63.8% had GID. Among 20 anti-Ro52/SSA positive patients, 70% (n=14) had GID compared to 62.2% (n=46) of anti-Ro52/SSA negative patients (p=0.517). Among the total sample (n=95), 67.4% reported GI symptoms, with a higher prevalence in the anti-Ro52/SSA positive group (85%) compared with the negative group (52%), although the difference was not statistically significant. The most prevalent symptom was gastroesophageal reflux (GER) (57.9% of the total sample), being more frequent in the anti-Ro/SSA positive group (80%) vs negative group (52%). A higher prevalence of diarrhea or fecal incontinence was also observed in seropositive patients (p=0.001). To be noted, none of the anti-Ro52/SSA positive patients reported oropharyngeal dysphagia, while it was present in 17.3% of the anti-Ro/SSA negative group (p=0.024). There were no significant differences in terms of esophageal dysphagia, dyspepsia, pseudo-obstruction and intestinal malabsorption. <h3>Conclusion:</h3> Anti-Ro52/SSA antibody positivity was not associated with GID in our study. Although it did not reach statistical significance (p=0.059), anti-Ro52/S positive patients tended to be more symptomatic. There may be associations between anti-Ro/SSA positivity and specific GI symptoms, such as GER and diarrhea/fecal incontinence. Further studies with larger sample sizes may be needed to confirm these trends and explore potential underlying mechanisms. <h3>REFERENCES:</h3> [1] Sánchez-Montalvá A, Fernández-Luque A, Simeón CP, Fonollosa-Plà V, Marín A, Guillén A, Vilardell M. Anti-SSA/Ro52 autoantibodies in scleroderma: results of an observational, cross-sectional study. Clin Exp Rheumatol. 2014 Nov-Dec;32(6 Suppl 86):S-177-82. Epub 2014 Nov 5. PMID: 25372801. [2] Meridor K, Sagy I, Molad Y. Anti-Ro/SS-A antibody is associated with worse pulmonary outcome and reduced overall survival in systemic sclerosis. Mod Rheumatol. 2022 Oct 15;32(6):1086-1093. doi: 10.1093/mr/roab118. PMID: 34927207. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>