ABS0930 PRESENCE OF HAND CONTRACTURES IN SYSTEMIC SCLEROSIS ARE MARKEDLY ASSOCIATED WITH DECREASED CAPILLARY DENSITY

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Background: Capillary rarefaction is one of the hallmark of systemic sclerosis (SSc) as well as is deteriorated hand function measured with various methods including performance tests and questionnaires. Objectives: To assess the relationship between capillary density and hand function in systemic sclerosis (SSc). Methods: A cross sectional study was performed among SSc patients over 18 years of age between 2017 and 2019 at the Department of Rheumatology and Immunology, University of Pécs Medical School, Hungary. Nailfold videocapillaroscopy (NVC) was performed and the presence of scleroderma pattern and the capillary density was recorded. Patients with poor quality of NVC images captured (>25% unable to be evaluated) were excluded. Joint damage was assessed using the Hand Anatomic Index (HAI), Hand Mobility in Scleroderma (HAMIS), delta Finger-to-Palm (dFTP) distance and the number of contractures. Self-administered questionnaires such as the Health Assessment Questionnaire – Disability Index (HAQ-DI), Quick Disabilities of the Arm, Shoulder and Hand Questionnaire (qDASH) and Cochin Hand Function Scale (CHFS) were used to investigate the functions. Joint disease activity was measured with the Disease Activity Score 28 (DAS28), Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI). Results: One hundred and sixty consecutive SSc patients (138 female; 22 male) were included. Fifty five percent had diffuse cutaneous SSc (dcSSc). Fifty-one cases (32%) had disease duration less than four years. NVC could be evaluated in 149 participants, 19 (11.9%) had early, 10 (6.3%) had active and 73 (45.6%) had late scleroderma pattern. Ninety patients (56.3%) had ≤7 loops per millimetre on NVC. Patients with dcSSc exhibited worse hand function measured by HAI (3.6 (2,9; 4.1) vs. 3.0 (2.4;3.6), p=0.001)), dFTP (93 (82;100) vs. 84 (72;95) P=0.007)) and number of contractures (0 (0;8) vs. 16 (0;28), p<0.001)) compared to their limited cutaneous counterparts. Decreased capillary density showed moderate correlation with the hand function tests across the whole cohort and moderate correlation among dcSSc patients and even in early SSc (Table 1). No significant associations were found between capillary density and joint disease activity. Based on binary regression analysis decreased capillary density using the cut off ≤7 loops per millimeter showed significant associations with the number of contractures (OR 1.07 95%CI 1.03;1.12, P=0.002) and CHFS test results (OR 0.957 95%CI 0.923;0.989, p=0.012). Conclusion: Decreased capillary density resulting in hypoxia in patients with decreased capillary density may contribute to the development of joint destruction and development of contractures beside the presence of other features having an impact in the development of decreased hand mobility (tendon inflammation, skin fibrosis and ulcers, and subcutaneous calcinosis). These changes may appear in the early stage of the disease and causes disability. REFERENCES: NIL . Table 1Spearmann correlation analysis of different hand function assessments and capillary density per millimeterSSc (n=160)lcSSc (n=72)dcSSc (n=88)early SSc (n=51)late SSc (n=109)rprprprprpHAQ-DI0.1070.2030.1980.125-0.0520.650.0610.7010.1640.099CHFS0.0750.3630.2210.087-0.1620.1640.0620.7010.1170.227HAMIS-0.2650.001-0.0440.748-0.402<0.001-0.2370.161-0.2480.012HAI0.1920.021-0.0120.9230.3370.0030.2510.1430.1530.122dFTP0.2510.003-0.0930.4860.473<0.0010.2760.1080.2090.039Nr of contractures-0.371<0.001-0.1340.307-0.434<0.001-0.5360.001-0.2950.003 Assessed with Spearman's rank correlations. HAQ-DI: Health Assessment Questionnaire - Disability Index; CHFS: Cochin Hand Function test Score; HAMIS: Hand Mobility Test in Scleroderma score; HAI: Hand Anatomic Index; dFTP: delta Finger-to-Palm distance . Acknowledgements: NIL . Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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