ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1688

Stem Cell-Enriched Lipotransfer Substantially Improves Measures of Appearance and Function Due to Facial Fibrosis in Systemic Sclerosis

Aurora Almadori1,2, Caroline Ryan2, Michelle Griffin3, Esther Hansen4, Christopher Denton5 and Peter Butler6,7, 1Plastic Surgery, Royal Free NHS Foundation Trust London Hospital, London, United Kingdom, 2Division of Surgery and Interventional Science, UCL, London, United Kingdom, 3Division of Surgery and Interventional Sclemce, UCL, london, United Kingdom, 4Clinical Psychology, Plastic Surgery, Royal Free London NHS Foundation Trust Hospital, London, United Kingdom, 5Department of Rheumatology, University College London, Royal Free Hospital, London, United Kingdom, 6Plastic Surgery, Royal Free London NHS Foundation Trust Hospital, London, United Kingdom, 7Division of Surgery and Interveitional Science, UCL, London, United Kingdom

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: , ,

Session Information

Date: Monday, November 6, 2017

Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's – Clinical Aspects and Therapeutics Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

Systemic sclerosis (SSc) is characterised by fibrosis of the skin and underlying connective tissue structures, together with localised loss of subcutaneous fat. Oro-facial fibrosis in systemic sclerosis (SSc) is almost always present in established cases and has major impact on oro-facial function, facial appearance, and quality of life. Based upon theoretical rationale for antifibrotic potential and improvement in connective tissue bulk we have evaluated the benefit of autologous stem cell enriched lipotransfer in a large cohort of SSc patients with a mean follow up period of 12 months after treatment, and objective assessment of clinical benefit including validated outcome tools.

Methods:

62 SSc patients with oro-facial fibrosis were assessed following oro-facial treatment with autologous stem cell enriched lipotransfer. Mean age was 56 (±11,59), 98% were female, 42% were affected by dcSS subset, and mean desease duration was 15,18 years (±8,81). Efficacy was assessed by pre- and post-operative mouth function (Mouth Handicap in Systemic Sclerosis Scale, MHISS), validated psychological measurements (Darriford Appearance Scale, DAS24; Hospital Anxiety and Depression Scale-anxiety, HADS; Brief Fear of Negative Evaluation Scale, BFNE; Visual Analogic Scale for mood, emotion, and distress, VAS), and volumetric assessment (3dMD imaging system).

Results:

We found a significant improvement of mouth function (MHISS) (6.85 ± 5.07) (p<0.0001) and all the psychological measures: DAS 24 (12.1 ± 9.5) (p<0.0001); HADS-anxiety (2.8 ± 3.2) (p<0.0001), HADS-depression (2.0 ± 3.1) (p<0.0001); BFNE (2.9 ± 4.3) (p<0.0001); VAS (3.56 ± 4.1) (p<0.0001). Multiple procedures further improved MHISS (p<0.05), DAS (p<0.0001) and VAS (p=0.01) scores. Disease subset or concomitant immunosuppression did not appear to affect outcome measures. Injected volume was retained variably in all facial areas: cheeks (93.7%), nasolabial folds (81.9%), nose (67.4%), chin (68.2%), upper lips (35.5%) and lower lips (27.3%). Concurrent immunosuppressive treatment with did not appear to influence the safety of efficacy of lipotransfer.

Conclusion:

Autologous stem cell enriched lipotransfer is a feasible treatment that reversed the effects of oro-facial fibrosis in SSc in this open cohort study. It has been shown to be both feasible and beneficial. Our findings warrant further testing in a randomised controlled trial.

Disclosure: A. Almadori, None; C. Ryan, None; M. Griffin, None; E. Hansen, None; C. Denton, None; P. Butler, None.

To cite this abstract in AMA style:

Almadori A, Ryan C, Griffin M, Hansen E, Denton C, Butler P. Stem Cell-Enriched Lipotransfer Substantially Improves Measures of Appearance and Function Due to Facial Fibrosis in Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/stem-cell-enriched-lipotransfer-substantially-improves-measures-of-appearance-and-function-due-to-facial-fibrosis-in-systemic-sclerosis/. Accessed .

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