{
  "abstract": "Introduction To assess the association between vascular disease and gastrointestinal (GI) involvement in systemic sclerosis (SSc) using the validated Unified Vascular Phenotype (UVP) score, and its predictive value for GI outcomes.Material and Methods We performed a time-to-event analysis from the EUSTAR database. Eligible patients had at least 2 follow-up visits with available information on UVP score components (telangiectasia, pitting scars, history of digital ulcers, FVC/DLCO ratio) and GI manifestations. UVP score (0-7 points) was calculated as previously described. Incident GI outcomes - oesophageal symptoms, upper abdominal symptoms, malabsorption, and lower GI symptoms - were assessed over follow-up. Associations between baseline UVP score and each outcome were evaluated using Cox proportional hazards models adjusting for confounding clinical and demographic covariates. UVP risk strata were plotted using Kaplan Meier curves.Results A total of 6463 patients (mean age 54 years, 84% female, median disease duration years) were included. Oesophageal symptoms occurred in 65.9%, upper abdominal symptoms in 34.5%, malabsorption in 3.4%, and lower GI symptoms in 41.5%.Higher baseline vascular score was independently associated with increased risk of all GI outcomes: oesophageal symptoms (HR 1.11, 95% CI 1.06-1.13), upper abdominal symptoms (HR 1.12, 95% CI 1.09-1.15), malabsorption (HR 1.29, 95% CI 1.21-1.38), and lower GI symptoms (HR 1.13, 95% CI 1.09-1.16). Associations remained significant after adjustment for age, sex, disease subset, Scl70/ACA status, disease duration, and baseline interstitial lung disease or pulmonary hypertension.Conclusions UVP score consistently predicts GI manifestations in SSc. Our findings suggest a pathophysiological link between vascular disease and GI involvement",
  "authors": [
    {
      "affiliations": [
        "Bordeaux University, CNRS, ImmunoConcEpT, UMR 5164, Bordeaux, Nouvelle-Aquitaine, France, Bordeaux, France",
        "Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK, Leeds, United Kingdom"
      ],
      "name": "Stefano Di Donato"
    },
    {
      "affiliations": [
        "Bordeaux University, CNRS, ImmunoConcEpT, UMR 5164, Bordeaux, Nouvelle-Aquitaine, France, Bordeaux, France",
        "CHU de Bordeaux, Rheumatology Department, Centre National de reference Des Maladies Autoimmunes et Systemiques Rares E, Bordeaux, France"
      ],
      "name": "Louis Bebear"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Northern Care Alliance NHS Foundation Trust, Salford Care Organisation, Salford, UK, Salford, United Kingdom",
        "Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Centre for Musculoskel, Manchester, United Kingdom"
      ],
      "name": "Michael Hughes"
    },
    {
      "affiliations": [
        "University of Texas Medical School, Houston, United States Minor Outlying Islands"
      ],
      "name": "Zsuzsanna Mcmahan"
    },
    {
      "affiliations": [
        "David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, USA, Los Angeles, United States Minor Outlying Islands"
      ],
      "name": "Elizabeth Volkmann"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Clinical Immunology, University of Lübeck, Germany., Lubeck, Germany"
      ],
      "name": "Gabriela Riemekasten"
    },
    {
      "affiliations": [
        "Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy, Milan, Italy",
        "Faculty of Medicine and Surgery, Vita Salute San Raffaele University, Milan, Italy, Milan, Italy"
      ],
      "name": "Marco Matucci-Cerinic"
    },
    {
      "affiliations": [
        "Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan, Tokyo, Japan"
      ],
      "name": "Masataka Kuwana"
    },
    {
      "affiliations": [
        "epartment of Rheumatology, Université de Paris, Cochin Hospital, Paris, France, Paris, France"
      ],
      "name": "Yannick Allanore"
    },
    {
      "affiliations": [
        "Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK, Leeds, United Kingdom"
      ],
      "name": "Francesco Del Galdo"
    },
    {
      "affiliations": [
        "Bordeaux University, CNRS, ImmunoConcEpT, UMR 5164, Bordeaux, Nouvelle-Aquitaine, France, Bordeaux, France",
        "CHU de Bordeaux, Rheumatology Department, Centre National de reference Des Maladies Autoimmunes et Systemiques Rares E, Bordeaux, France"
      ],
      "name": "Marie-Elise Truchetet"
    }
  ],
  "title": "P.181 Vascular disease burden predicts gastrointestinal manifestations in systemic sclerosis: longitudinal analysis from the EUSTAR cohort",
  "uid": "a6c554f3-f0ab-52ad-8122-873e3e912d02"
}