Session Type: ACR Concurrent Abstract Session
Session Time: 2:30PM-4:00PM
Background/Purpose: Despite the fact that up to 90% of scleroderma (SSc) patients are affected by gastrointestinal (GI) dysmotility, features associated with severe GI disease are not well-defined. We sought to identify such features by studying a large cohort of SSc patients requiring parenteral nutrition (TPN) for severe GI dysmotility and SSc controls with mild or no GI symptoms.
Results: There were 59 TPN dependent SSc patients, and 1,744 SSc patients with mild or no GI symptoms. 1,456 (81%) of patients were female and 347 (19%) of patients were male. In the univariate analysis, we identified male sex (OR 2.2, CI 1.28, 3.86; p = 0.005), diffuse cutaneous disease (OR 2.62, CI 1.53, 4.45; p = <0.001), and black race (OR 2.5, CI 1.42, 4.39; p = 0.001), as features associated with severe GI dysmotility in SSc. Myopathy was also found to associate with severe SSc GI dysmotility (OR 4.5, CI 2.61, 7.79; p = <0.001). After adjusting for potential confounders (age, disease duration, and history of diabetes), male gender (OR 2.6, CI 1.17, 5.90; p=0.02), diffuse disease (OR 2.79, CI 1.20, 6.47; p = 0.017), and myopathy (OR 3.6, CI 1.54, 8.33; p = 0.003), all remained significantly associated with severe GI dysmotility.
Conclusion: We utilized the largest reported cohort to date of TPN-dependent SSc patients to define phenotypic features associated with severe GI dysmotility. Our results demonstrate that male sex, diffuse cutaneous disease, and myopathy are significantly associated with severe SSc GI dysmotility. As myopathy is a complication associated with severe SSc GI dysmotility, defining autoantigens common among smooth and skeletal muscle may provide insight into disease pathogenesis.
To cite this abstract in AMA style:McMahan Z, Casciola-Rosen L, Wigley FM. Diffuse Scleroderma, Male Sex, and Myopathy Are Associated with Severe Gastrointestinal Dysmotility in Scleroderma [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/diffuse-scleroderma-male-sex-and-myopathy-are-associated-with-severe-gastrointestinal-dysmotility-in-scleroderma/. Accessed July 30, 2021.
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