THU0427 Comparable cardiovascular disease and neoplasm rates but higher frequency of depression in systemic sclerosis versus rheumatoid arthritis: a multicentre comparative study of comorbidities

Background An increased burden of comorbid conditions negatively impacts patients’ outcomes, leads to increased mortality and seems to characterise all chronic systemic connective tissue diseases. Systemic Sclerosis (SSc) is associated with the highest mortality rate comparing to other diseases, whereas data regarding epidemiology and clinical expression of SSc comorbidities is limited. In contrast, comorbidities of rheumatoid arthritis (RA), and especially the increased rate of cardiovascular disease, are better established. Objectives To compare the prevalence of common comorbidities in SSc versus RA in a large multicentre case-control study from 5 academic centres in Greece. Methods Between 2016 and 2017 consecutive SSc patients (n=408, mean age: 58.6 years, 88% women) were matched 1:1 for age and gender with 408 RA patients. Evaluated comorbidities were dyslipidemia, diabetes mellitus, arterial hypertension, coronary artery disease, stroke, chronic obstructive pulmonary disease, osteoporosis, neoplasms and depression. Differences were examined by x 2 test. Results The prevalence of dyslipidemia (18.4% vs 30.1%, p=0.001) and diabetes mellitus (5.6% vs 11.8%, p=0.007) was lower in SSc than RA patients and there was no difference regarding arterial hypertension (31.8% vs 30.6%, respectively, p=0.742) between the two groups. Disease duration, smoking and alcohol consumption were comparable between SSc and RA groups. While there was a trend for lower prevalence of ischaemic strokes in SSc than RA (0.4% vs 2.2%, p=0.085), comparable rates of coronary artery disease were noted (2.7% v.s 3.7%, p=0.445). No differences were found between SSc and RA patients regarding chronic obstructive pulmonary disease (5.2% vs 3.7%, respectively. p=0.326), osteoporosis (24% vs 22%, p=0.668) and neoplasms (1.1% vs 1.7%, p=0.534). Depression requiring treatment was more prevalent in SSc compared to RA patients (22% vs 12%, p=0.001). Conclusions Despite almost half prevalence of dyslipidemia and diabetes mellitus in SSc versus RA patients, the cardiovascular comorbidity burden appears to be similar between the two diseases. SSc has no higher prevalence of neoplasms than RA but a greater negative impact on quality of life, as clearly more SSc patients develop depression compared to RA patients. Acquisition of prospective data is currently underway. Disclosure of Interest None declared