P020 Audit of bosentan use in Rapid Access to Digital Ulcer Clinic (RADUC) in systemic sclerosis: a single-centre experience

Abstract Background/Aims Systemic sclerosis (SSc) is an autoimmune disease characterised by microvascular injury and excessive fibrotic responses. About 55% of SSc patients develop digital ulcers (DUs). The revised “Clinical commissioning policy for the prescription of sildenafil and bosentan for the treatment of digital ulceration in SSc in adults” recommends oral agents, sildenafil and bosentan, before IV-prostanoids. Patients are eligible for bosentan with either severe vasculopathy (causing/threatening tissue loss despite optimal treatment) or ≥ 3 DUs. A dedicated specialist nurse-led Rapid Access to Digital Ulcer clinic (RADUC) is established in our centre to manage SSc patients with DUs. This audit aimed to evaluate the use of bosentan for the treatment of severe DUs in SSc. Methods We analysed data from patients who started bosentan between 05-2017 and 09-2022 at our centre. Patients with pulmonary hypertension were excluded. Data were collected at baseline and 6-months after starting bosentan using clinical records/self-completed questionnaires. Quality-of-life was measured with SHAQ 3-domains (1-disability, 2-disability using aids, 3-pain). Data were analysed using Prism v9.4 and expressed as mean±standard deviations. Wilcoxon/Spearman was applied as appropriate. P-values