Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Gastric antral vascular
ectasia (GAVE) is an increasingly recognized cause of upper gastrointestinal
bleeding in patients with systemic sclerosis (SSc). These patients may
require frequent interventions, which negatively impact quality of life.
There is currently no defined role for immunosuppressive therapy in the
treatment of GAVE. The goal of this study was to determine whether
immunosuppressive therapy, used for any indication, also has a role in reducing
the frequency of interventions for GAVE in patients with SSc.
A retrospective chart review
was performed on patients that were seen within the past 10 years at our
institution who had SSc complicated by GAVE. Data on demographic and
clinical characteristics were collected. Types of immunosuppressive
therapies and the time periods used were recorded. Intervention rates
(hospitalizations, blood transfusions, and endoscopic therapies) were compared
using repeated measures Poisson regression models to account for the different
medication periods for each patient.
Forty-eight patients with
SSc complicated by GAVE were identified (Table 1). Twenty-nine received
immunosuppressive therapy. Those who received immunosuppressive therapy
had anti-centromere antibodies less often than those who did not receive
therapy (17.2% versus 52.6%, p=0.010). Other patient characteristics were
not significantly different between the two groups. The most commonly used
therapy was mycophenolate (n=14), followed by glucocorticoids (n=11),
hydroxychloroquine (n=7), cyclophosphamide (n=4), intravenous immunoglobulin
(n=3), methotrexate (n=3), and azathioprine (n=1). When receiving
immunosuppressive therapy, patients required therapeutic endoscopies less
frequently (0.51/year versus 1.37/year, p=0.009) (Table 2). This decrease
in frequency was more pronounced with mycophenolate in particular (0.25/year
versus 1.37/year, p=0.013). There were no significant differences in
hospitalization or blood transfusion frequencies.
Conclusion: Mycophenolate may have the potential to alter
the course of disease in patients who have GAVE associated with SSc, and can be
considered in those who require frequent therapeutic endoscopies. Further
studies are needed to confirm these findings.
To cite this abstract in AMA style:Lin T, Bena J, Morrison S, Chatterjee S. Mycophenolate Decreases the Frequency of Endoscopic Therapy for Gastric Antral Vascular Ectasia in Patients with Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/mycophenolate-decreases-the-frequency-of-endoscopic-therapy-for-gastric-antral-vascular-ectasia-in-patients-with-systemic-sclerosis/. Accessed April 14, 2021.
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