SAT0302 Evaluation of subclinical gut inflammation using faecal calprotectin level and colonic mucosal biopsy in patients with psoriasis and psoriatic arthritis

Background The association between gut inflammation and ankylosing spondylitis is well established, while it is not so in psoriatic arthritis(PsA). Objectives To study the prevalence of subclinical gut inflammation in PsA and Psoriasis(PsO) patients using faecal calprotectin levels and colonic mucosal biopsies and its correlation with disease phenotypes and activity scores. Methods Fifty patients with active PsA and hundred with active PsO were recruited.Faecal calprotectin levels of more than 43.2 µgm/gm by ELISA was considered positive.Sigmoidoscopy and multiple colonic mucosal biopsies were done in twenty PsA patients and eight PsO patients.Thirty consecutive patients with irritable bowel syndrome(IBS)according to ROME III criteria were disease control population.Mann Whitney u test and Kruskal Wallis H test were used. Results Baseline characteristics are given in table 1.Faecal calprotectin level was elevated in 29 (58%) PsA patients and 26 (26%) PsO patients (p=0.000). The mean value of faecal calprotectin was higher in PsA patients than PsO(86.6±81.5 µgm/gm vs 32.9±48.1 µgm/gm,p=0.000).The Odds for a positive faecal calprotectin level in PsA was 3.9 (95% CI 1.9–8.0) in comparison to PsO. Faecal calprotectin levels were significantly higher in PsA patients with high body surface area(BSA) and psoriasis area and severity index(PASI) scores.Those with axial phenotype had higher calprotectin levels and the levels correlated with BASDAI. Mean faecal calprotectin level was 22.0±18.5 µgm/gmin IBS patients which was significantly lower than PsA patients (0.002)but was comparable with that of PsO patients(p=0.8). Sigmoidoscopy was normal in all PsO patients while two PsA patients had mucosal erythema. Fifteen PsA and all PsO patients showed increased lymphoplasmocytic infiltration of lamina propria. Evidence of active colitis with cryptitis was seen in two and collagenous colitis was seen in seven PsApatients (figure 1). No PsO patient had active or collagenous colitis. Conclusions Subclinical gut inflammation was significantly higher in PsA patients in comparison to PsO patients and is more prevalent among those with axial phenotype. Acknowledgements IRA Disclosure of Interest None declared