Ab1230 Systemic Sclerosis: Clinical Features and Health Related Quality of Life at Groote Schuur Hospital, Cape Town

Background: There is no published research from sub-Saharan African on pain, fatigue or disability amongst persons living with systemic sclerosis (SSc). Objectives: To describe the clinical characteristics and health-related quality of life (HRQoL) of persons with SSc attending a state-sector academic hospital in South Africa (SA). Methods: A cross-sectional study of consenting outpatients (≥18 years; meeting ACR/EULAR 2015 SSc classification criteria). Clinico-demographic details and patient-reported outcome measures including the Brief Pain Questionnaire (BPI), Health Assessment Questionnaire (HAQ-DI), Functional Assessment of Chronic illness Therapy-Fatigue (FACIT-F) and the Hospital Anxiety (HADS-A) and Depression Scale(HADS-D) were collated. Patients with no or mild functional disability (HAQ-DI ≤0.5) were compared to those with moderate to severe disability (HAQ-DI>0.5). Results: Of 77 participants, (67 females), the mean (SD) age at diagnosis was 44.1(12.4) and disease duration was 10.9(9.2) years. The majority (58%) were unemployed and 26% depended on a state disability grant. Half had diffuse disease (50.5%), the majority had Raynaud's (93.5%) and digital ulcers (64.9%), and the mean (SD) modified Rodnan skin score was 11.3(12.1). Gastroesophageal reflux was noted in 83.1% and 49.3% had interstitial lung disease. Positive ANA, anti- topoisomerase and anti-centromere antibodies were present in 75.3%, 19.4% and 13.0% respectively. The mean (SD) HAQ-DI was 1.2(0.8), indicating moderate to severe disability. The worst scores were seen in the "reach" domain, with 45% scoring >2 ("with much difficulty") for reaching an object above the head. Moderate or severe pain was experienced by 44.2% and 18.2%, and moderate or severe fatigue in 52.7% and 12.7%. Severe anxiety or depression was noted in 28.6% and 24.6% respectively. Patients with functional disability had significantly worse fatigue, pain (both severity and interference scores), anxiety and depression scores, and were more likely to haver digital ulcers, musculoskeletal, lung or gastrointestinal involvement, although these clinical features did not reach statistical significance. Conclusion: Amongst indigent state-sector SScl patients, functional disability is prevalent and is significantly associated with fatigue, pain and poor mental health. Future studies will assess the effectiveness of interventions including occupational therapy and psychosocial therapy. REFERENCES: NIL. Acknowledgements: Department of Medicine, Rheumatology University of Cape Town. Disclosure of Interests: None declared.