Document resource
Introduction Gastro-oesophageal reflux disease (GORD) affects up to 90% of systemic sclerosis (SSc) patients. Chronic oesophageal acid exposure can result in complications including the formation of oesophageal strictures (OS). Proton pump inhibitors (PPIs) can alter gastric acid pH and improve GORD symptoms, however there have been no recent studies evaluating the prevalence of SSc-OS since these medications became widely available. Our aim was to investigate the prevalence of SSc-OS over time and identify risk factors associated with OS.Material and Methods Consecutive patients from the Australian Scleroderma Cohort study (ASCS) who met ACR/EULAR criteria for SSc were included. OS was defined as characteristic findings seen on gastroscopy, patient-reported OS or symptoms consistent with OS. Time to development of OS from disease onset was presented on Kaplan-Meier survival curves. Multivariable logistic regression analysis was used to identify factors associated with SSc-OS.Results Oesophageal strictures affected 191/1543 patients (12.4%) and were associated with longer disease duration, gastric antral vascular ectasia (GAVE), oesophageal dysmotility, reflux oesophagitis and myocardial disease on multivariable logistic regression analysis (p<0.05). The proportion of patients with SSc-OS decreased over epochs of study with a prevalence of 22.5% for those diagnosed before 1990 compared to 10.3% diagnosed after 2000. Disease duration at time of SSc-OS diagnosis increased over epochs ( figure 1). Compared to SSc patients diagnosed before 1990, those who were diagnosed between 2000-2010 and 2010-2023 were significantly less likely to have OS on multivariable logistic regression analysis (OR 0.45 and 0.42 respectively, p=0.002).Conclusions SSc-OS is associated with longer disease duration and other gastrointestinal SSc manifestations, with prevalence decreasing over epochs.Abstract P.168 Figure 1