FRI0375 Clinical features of systemic sclerosis in patients with and without recurrent digital ulcers: findings from the duo registry

Background Digital ulcers (DU) are painful and frequent in patients with systemic sclerosis (SSc), with ~30% of patients experiencing DU at least once a year. Objectives This analysis describes SSc clinical features in patients with different types of DU recurrence. Methods The DUO Registry is a European, prospective, observational cohort of SSc patients with DU. At enrolment, all have current and/or previous DU. Enrolled patients who had ≥2 follow-up (FU) visits and a 2-year observation period from Apr 2008 to Nov 2012 were categorised according to their DU recurrence pattern. Patients were categorized into 4 DU recurrence groups: non-active (no DU at FU visits and no new DU between visits), episodic (only 1 FU visit with a DU), recurrent (≥2 FU visits with DU and ≥1 visit with no DU) and chronic (DU present at every FU visit). Results Of the 1273 patients with available data, 1056 (83%) were female, 459 (36.1%) were categorised as non-active, 274 (21.5%) as episodic, 398 (31.2%) as recurrent and 142 (11.1%) as chronic; the mean age (SD) at enrolment was 55.1 (13.8), 54.9 (13.5), 52.0 (14.3) and 51.8 (12.5) years in the non-active, episodic, recurrent and chronic groups, respectively. 465 (36.5%) patients had diffuse SSc: 140 (30.1%) non-active, 94 (20.2%) episodic, 161 (34.6%) recurrent, 70 (15.1%) chronic; 659 (51.8%) patients had limited SSc: 252 (38.2%) non-active, 150 (22.8%) episodic, 191 (29.0%) recurrent and 66 (10.0%) chronic. Anti-centromere antibodies were present in 50%, 41.1%, 40.1% and 29.9% of non-active, episodic, recurrent and chronic patients, respectively. 63.4% of the chronic and 51.1% of the recurrent patients had anti-Scl 70 antibodies, vs. 36.5% and 41.5% of non-active and episodic patients. Pulmonary arterial hypertension was present in 17.9% of non-active patients, vs. 10.6%, 15.1% and 7.7% of episodic, recurrent and chronic patients. Lung fibrosis was found in 36.8%, 36.1%, 41.7% and 52.1% of non-active, episodic, recurrent and chronic patients, respectively. Mean age at first DU (43.2 years, SD 14.6) and age at first Raynaud phenomenon (RP; 35.8 years, SD 14.0) were earliest in chronic patients. Median time from first RP to enrolment was 9.9, 10.6, 10.8 and 13.9 years in non-active, episodic, recurrent and chronic patients, respectively. Median time from first DU to enrolment was 4.2, 4.4, 4.3 and 6.4 years, respectively. At enrolment, 52.2% of the non-active patients had no DU, vs. 24%, 21.5% and 2.2% of the episodic, recurrent