Ab1225 Comparison of the Acute Effects of Intravenous Iloprost on Finger Power Doppler Ultrasound in Scleroderma Patients in Two Infusion 4 Weeks Apart

Background: In a previous study we have demonstrated that powerDoppler US (PDUS) is able to detect the iloprost (ILO) acute effect on subcutaneous vascularization of periungual (PU) and finger pulp (FP) subcutaneous areas in SSc patients with long-lasting disease. Few studies have explorated the chronic effect of ILO infusion in this group of patient. Objectives: We aim to evaluate the variation of the acute vascular effects of ILO infusion at baseline (T0) and at the second ILO infusion 4 weeks apart (T1). Methods: Twenty-eight consecutive SSc patients who met the ACR/EULAR criteria for SSc referring to our tertiary center for ILO infusion were enrolled in the study. FP and PU vascularization of the 1st, 2nd and 3rd finger of the dominant hand were evaluated before (ILO-B) and after (ILO-A) ILO infusion (dosage 0.5-2.0 ng/kg/min for 4-6 hours) at baseline (T0) and at ILO infusion 4 weeks later (T1) using an Esaote MylabClassC, (Genoa, Italy) machine equipped with a 22-8 Mhz multifrequency linear probe. All the exams were performed after at least 30 minutes of acclimatation in a room with an ambient temperature ranging from 20 to 24 ° C by the same operator (PM). All the images with the highest presence of PD signal were stored for subsequent examination by a rheumatologist (ST) blind to images sequency. The presence of PD signal in every image was scored according to a semiquantitative 0-5 scale. The value of each finger (FP & PU) were summed up to obtain a total patient PD score (TotPDS). No improvement in TotPDS score was defined when the difference between ILO-A and ILO-B TotPDS (Δ TotPDS) was < 0; while improvement was considered when Δ TotPDS was > 1. Values of TotS and its variations (ILO-B minus ILO-A) at T0 and T1 were compared by T-test for paired samples. Clinical demographic and US data entered in a multivariate logistic regression analysis to evaluate the presence of factors predictive of TotS variation at T0 and T1. Results: Clinical and laboratory features of the 28 enrolled pts are reported in Table 1. TotPDS variations after the 1st and 2nd ILO infusion are reported in table 1. There were no statistical differences between ILO-B and ILO-A TotPDS at T0 and T1 examination. T0 Δ TotPDS was statistically lower than T1 Δ TotPDS. T1 Δ TotPDS was grater than T0 Δ TotPDS in 17 pts (60.7%), unchanged or lower in 11 pts (39.3%). At multivariate logistic regression analysis no baseline clinical, demographic or US characteristics of the patients were predictive of the TotPDS positive variation between T0 and T1 ILO infusion. Conclusion: PDUS examination of the PU and FP area can demonstrate an ILO chronic effect in SSc patients with long-lasting disease. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.