Analysis of Clinical Characteristics of Patients with Systemic Sclerosis and Gastric Antral Vascular Ectasia.

Background/

Objectives

Gastric antral vascular ectasia (GAVE) is a gastrointestinal manifestation associated with systemic sclerosis (SSc) that can lead to significant morbidity. This study aimed to characterise and compare the clinical profiles, laboratory findings, therapeutic approaches and survival outcomes of SSc patients with and without GAVE, based on data obtained during their first oesophagogastroduodenoscopy (EGD).

Methods

A total of 269 patients who had undergone at least one EGD were selected. Twenty-seven were diagnosed with GAVE and compared with the remaining 242.

Results

The overall prevalence of GAVE in SSc patients was 10%. Patients with GAVE had specific features such as a higher median age SSc onset (56.6 vs 48.0 years, p = 0.001), a higher prevalence of Barrett's oesophagus (14.8% vs. 3.7%, p = 0.011), intestinal involvement (37% vs. 18.6%, p = 0.024) and a trend towards a lower prevalence of interstitial lung disease (25.9% vs. 45.0%, p = 0.057). A higher frequency of early or active Cutolo capillaroscopy pattern (84.6% vs. 62.4%, p = 0.025), greater frequency of anti-centromere antibodies (63.0% vs. 42.1%, p = 0.039) and a trend towards a lower proportion of anti-topoisomerase I (3.7% vs. 18.6%, p = 0.052) was also observed. No difference was found in the prevalence of anti-RNA polymerase III antibodies, survival or mortality.

Conclusions

SSc patients with GAVE exhibit a distinct phenotype characterised by older age at disease onset, gastrointestinal involvement, anti-centromere antibodies and early or active capillaroscopic pattern, without differences in survival.