AB0711 The Impact of Anemia on Systemic Organ Damage in Systemic Sclerosis

Abstract

BackgroundSystemic sclerosis (SSc) is a systemic autoimmune disease with multiple organ damage. Scleroderma Clinical Trials Consortium (SCTC) has developed the Damage Index (DI) in SSc to quantify organ damage in SSc[1]. Anemia has been implicated as an independent prognosis factor for mortality and organ complications in systemic sclerosis (SSc), while the relationship between anemia and the weighted organ damage index has not been reported.ObjectivesTo determine the degree and feature of organ damage in SSc patients with or without anemia in a population of patients from Peking University Third Hospital SSc cohort (PKUTH-SSc).MethodsPatients were recruited from PKUTH-SSc between January, 2010 and December, 2021. The diagnosis of anemia was based on the reduced hemoglobin (Hb) concentrations (<120g/L for female and <135g/L for male). The demographics, clinical characteristics, laboratory parameters, autoantibodies medication and SCTC-DI were collected. Student‘s t-test and Chi-square were used.ResultsAs shown in Table 1, a total of 155 patients were enrolled in PKUTH-SSc cohort, 70 (45.2%) patients developed anemia, older and lower BMI than non-anemia patients. The inflammatory indices, ESR and CRP, were higher in anemia patients, indicating anemia was more common in patients with active disease. Consistent with the result that the positive rate of anti-SSA and anti-SSB antibody was higher in anemia patient, the sicca symptoms were also reported in nearly half of anemia patients. In anemia patients, the Gastrointestinal system related damage, Oesophageal dysmotility, Pseudo-obstruction and weight loss, and renal damage were more frequently discovered. Moreover, anemia patients were more likely to develop moderate to high organ damage risk, demonstrating the necessary of regular organ damage follow-up for anemia patients.Table 1.Clinical parameters and SCTC-DI of SSc patients with or without anemiaAnemiaN=72Non-anemiaN=83p valueAge at baseline (years)54.43±1.8849.64±1.320.034*BMI (kg/m2) (meanyear20.49±0.4022.46±0.39<0.001*ESR32.48±3.0616.67±1.83<0.001CRP1.20±0.220.64±0.110.014*Anti-SSA22 (31.4%)13 (15.3%)0.017*Anti-SSB8 (11.4%)1 (1.2%)0.018*Musculoskeletal and skin2.22±.22u1.11±.11u<0.001*Sicca symptoms31 (44.3%)22 (25.9%)0.016*Vascular0.67±.67u0.59±.59u0.628Gastrointestinal2.09±.09r1.31±.31r<0.001*Oesophageal dysmotility27 (38.6%)18 (21.2%)0.018*Pseudo-obstruction5 (7.1%)0 (0.0%)0.017*BMI<18.5 kg/m2 or weight loss >10% in the last 12 months40 (57.1%)31 (36.5%)0.010*Respiratory2.24±.24i1.59±.59i0.132Cardiovascular0.94±.94i0.66±.66i0.468Renal0.21±.21l0.00±.00l0.027*History of SRC4 (5.7%)0 (0.0%)0.040*SCTC-DI8.37±.37-5.25±.25-<0.001*Moderate to high damage score48 (68.6%)31 (36.5%)<0.001*ConclusionAnemia is associated with distinct organ damage behaviors and higher disease progression risk in SSc. Specifically Sicca symptoms and gastrointestinal, renal system were more common in SSc patients with anemia.