Correlation Between Raynaud's Condition Score, Nailfold Videocapillaroscopy and Laser Speckle Contrast Analysis in Secondary Raynaud's Phenomenon Due to Systemic Sclerosis

Barbara Ruaro¹, Elisa Alessandri ², Massimo Ghio ³, Carmen Pizzorni ⁴, Sabrina Paolino ⁴, Andrea Casabella ⁵, Antonio De Tanti ⁶, Alberto Sulli ⁷ and Maurizio Cutolo ⁸, ¹1 Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; 2 Cardinal Ferrari Centre, S. Stefano Rheabilitation, Fontanellato (Parma), Italy, Genoa, Italy, ²1. Research Laboratory and Academic Division of the Clinical Rheumatology Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, Genoa, Italy, ³Research Laboratory and Academic Division of the Clinical Rheumatology Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, Genoa, Italy, ⁴Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, Genoa, Italy, ⁵1 Research Laboratory and Academic Division of the Clinical Rheumatology Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, Genoa, Italy, ⁶2 Cardinal Ferrari Centre, S. Stefano Rheabilitation, Fontanellato (Parma), Italy, Fontanellato, Italy, ⁷Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS Ospedale Policlinico San Martino, Genoa, Italy, Genoa, Italy, ⁸Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS Ospedale Policlinico San Martino, Genoa, Italy, Genoa, Italy

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: nailfold capillaroscopy and Blood perfusion, Raynaud's Condition Score, Raynaud's phenomenon, Scleredema

Session Information

Date: Monday, November 11, 2019

Title: Systemic Sclerosis & Related Disorders – Clinical Poster II

Session Type: Poster Session (Monday)

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

Background/Purpose: To evaluate any correlation between the Raynaud’s Condition Score (RCS) and the morphological and functional methods available to evaluate microvascular damage in systemic sclerosis (SSc) patients (1-4).

Methods: Sixty-six SSc patients with Raynaud’s phenomenon (RP) were enrolled during routine clinical assessment after informed written consent (60 women and 6 men, mean age 61±17 years, mean RP duration 11±9 years, mean disease duration 7±5 years). RCS, frequency and duration of Raynaud’s attacks were assessed together. All patients had been on a stable drug regimen for at least two months, all vasodilator drugs had been suspended at least four week before evaluation (cyclic prostanoids, endothelin-1 receptor antagonists, ACE-inhibitors, calcium channel blockers). Patients were allowed to continue other treatments: hydroxychloroquine (5 patients), methotrexate (3 patients), cyclosporine A (10 patients), mycophenolate (6 patients), proton-pomp inhibitors (21 patients).
Nailfold videocapillaroscopy (NVC) was performed in each patient to assess any morphological microvascular damage and the microangiopathy evolution score (MES) was calculated (2). Blood perfusion (BP) was measured by Laser Speckle Contrast Analysis (LASCA) (3) at the level of fingertips, periungual areas, dorsum and palm of the hands. Statistical analysis was carried out by non-parametric tests.

Results: A positive correlation was observed between RCS and BP at the level of the fingertips, periungual areas and palms of the hand (p< 0.01, r=0.85, for all areas). There was no statistically significant correlation between RCS and BP at the dorsum hand level, whilst there was a positive correlation between RCS and MES (p=0.03, r=0.79).
RCS for RP activity (possible range 0-10) was 5±2, frequency (number of event during the day) was 2±1 and duration (in minutes) was 14±6 of Raynaud’s attacks.
BP at the level of fingertips was 67±17 PU, periungual areas 60±16, palm of hands 59±18 and dorsum of hand 49± 22. The MES average value was 3±2.

Conclusion: Our findings demonstrate a significant correlation between the RCS and the morphological and functional methods used to evaluate microvascular damage in SSc patients.

References

Cutolo M, et al. Expert Rev Clin Immunol. 2019:1-12. 2. Ingegnoli F, et al. Semin Arthritis Rheum. 2017;46:609-614. 3. Ruaro B, et al. Ann Rheum Dis. 2014; 73: 1181-5. 4. Sulli A, et al. Ann Rheum Dis 2008; 67: 885-7.

Disclosure: B. Ruaro, None; E. Alessandri, None; M. Ghio, None; C. Pizzorni, None; S. Paolino, None; A. Casabella, None; A. De Tanti, None; A. Sulli, None; M. Cutolo, Boehringer, Actelion, Celgene, Bristol-Mayer Squibb, 2.

To cite this abstract in AMA style:

Ruaro B, Alessandri E, Ghio M, Pizzorni C, Paolino S, Casabella A, De Tanti A, Sulli A, Cutolo M. Correlation Between Raynaud’s Condition Score, Nailfold Videocapillaroscopy and Laser Speckle Contrast Analysis in Secondary Raynaud’s Phenomenon Due to Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/correlation-between-raynauds%e2%80%afcondition%e2%80%afscore-nailfold-videocapillaroscopy-and-laser-speckle-contrast-analysis-in-secondary-raynauds-phenomenon-due-to-systemic-sclerosis/. Accessed .

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