{
  "abstract": "Introduction Gastrointestinal (GI) involvement is a common and serious complication in patients with systemic sclerosis (SSc), often leading to poor prognosis and posing ongoing challenges in diagnosis and management. However, the effect of immunosuppressive therapy on GI symptoms in SSc, particularly among Asian populations, remains inadequately studied. This study employed the University of California, Los Angeles/Scleroderma Clinical Trials Consortium Gastrointestinal Tract Instrument 2.0 (GIT 2.0)—a validated patient-reported outcome measure sensitive to changes in GI symptom severity and related quality of life—to evaluate GI involvement in a large Chinese SSc cohort and assess whether immunosuppressive treatment improves GI outcomes.Material and Methods We enrolled outpatients from Peking Union Medical College Hospital between October 2024 and August 2025. Baseline data, including GIT 2.0 scores and clinical details, were collected at initial visits. A follow-up visit after 6±2 months with completed GIT 2.0 questionnaires was required for inclusion. Immunosuppressive treatment was defined as use of Janus kinase inhibitors (tofacitinib or upadacitinib), rituximab, tocilizumab, methotrexate, mycophenolate mofetil, or glucocorticoids (>=10 mg prednisone equivalent daily) for more than three months prior to baseline or at least six months during observation. Linear regression was performed with follow-up GIT 2.0 total score as the dependent variable, and treatment exposure, GI medications, and baseline factors as independent variables, adjusting for age and sex.Results Among 224 patients at baseline ( table 1), 72 completed follow-up (table 2). At baseline, patients with diffuse cutaneous SSc (dcSSc) had significantly higher GIT 2.0 scores in diarrhea, social functioning, emotional well-being, and total score compared to those with limited cutaneous SSc (lcSSc) (all p < 0.05, figure 1). Cardiovascular involvement was tend to associated with worse GI symptoms in diarrhea (p=0.054) and higher total scores (p=0.077). SSc patients with myositis were found to suffer from worse social function (p=0.025), emotional well-being (p=0.006) and higher total score (p=0.017) (figure 2).At follow-up, diarrhea score (p=0.008) was significantly different between the patients with and without immunosuppression treatment (table 2), though no significant within-group changes were observed in total GIT 2.0 scores from baseline (figure 2). Linear regression indicated that prokinetic agents may influence GI outcomes (table 3).Conclusions These findings suggest that dcSSc, cardiovascular involvement, and myositis are associated with more severe GI symptoms. Immunosuppressive treatment may alleviate specific GI manifestations such as diarrhea, but its overall efficacy requires further validation.Abstract P.164 Figure 1GIT 2.0 result com parison in based line SSe patients between subtypes, cardiovascular involvement +/- and myositis+/ -Abstract P.164 Figure 2GIT 2.0 result comparison between baseline andfollow-up visit in the immunosuppression treatment patientsAbstract P.164 Table 1Basic information of 224 SSc patients at baseline visit. SSc diagnosis score, the score when diagnosing with the 2013 American college of rheum atology European alliance of associations for rheun atology classification criteria for SSc; RP, reynolds phenom enon; DU, digital ulcers; PAH, pulmonary arterial hypertension; SRC, scleroderma renal crisis; ILD, interstitial lung diseaseAbstract P.164 Table 2Basic information of patients followed up (62 months), immunosuppression treatment defined as exposure to one or more of the following drugs for treatment for >3 months during the 6 months before baseline, or at least 6 months during the observation period: Janus Kinase Inhibitor inhibitors (Tofacitinib or Upadacitinib), rituximab, tocilizumab, methotrexate (MTX), mycophenolate mofetil (MMF), and glucocorticoids in a daily dose of ≥10 mg prednisone equivalentAbstract P.164 Table 3Logistic regression result showed that the usage of gastrointestinal prokinetic agents might be an influencing factor on the GIT 2.0 total scores",
  "authors": [
    {
      "affiliations": [
        "Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of M, Beijing, China"
      ],
      "name": "Shihan Xu"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of M, Beijing, China"
      ],
      "name": "Haochen Huang"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of M, Beijing, China"
      ],
      "name": "Bo Yu"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of M, Beijing, China"
      ],
      "name": "Lu Yuan"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of M, Beijing, China"
      ],
      "name": "Xiaofeng Zeng"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of M, Beijing, China"
      ],
      "name": "Mengtao Li"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of M, Beijing, China"
      ],
      "name": "Dong Xu"
    }
  ],
  "title": "P.164 Evaluating gastrointestinal involvement in systemic sclerosis using the GIT 2.0 instrument and the impact of immunosuppressive therapy in a Chinese cohort",
  "uid": "ac833998-ff22-5a78-b28f-5fcc0bc355ba"
}