SYSTEMIC SCLEROSIS OVERLAP AND NON-OVERLAP SYNDROMES SHARE SIMILAR CLINICAL CHARACTERISTICS BUT DRAMATICALLY DIFFERENT TREATMENT.

Background: Dactylitis is a common feature of PsA, occurring in 16 to 49% of PsA patients, mostly in early disease. Objectives: To assess the effectiveness of steroid injection (local treatment, LT) into the digital flexor tendon sheath for the treatment of active dactylitis in PsA patients as compared to systemic treatment (ST) alone. Methods: 73 hand dactylitis were assessed in a prospective observational study by the Leeds Dactylitis Index basic (LDI-b) score and evaluated for pain (VAS pain), functional impairment (VAS-FI). In accordance with EULAR and GRAPPA recommendations, steroid injection was proposed to all patients. Patients who refused LT were treated with oral NSAIDs. The patients of the two groups continued baseline therapy with csDMARDs or corticosteroids. The clinical outcomes were measured at baseline, 1 month (T1) and 3 months (T3) by assessors blinded to this study. Results: The reduction of VAS-pain, VAS-FI and LDI-b values was statistically significant higher in the LT group as compared to the ST group, both at T1 (p Conclusion: For the first time, we show the effectiveness of steroid injection into the digital flexor tendon sheath in improving clinical aspects and symptoms of hand psoriatic dactylitis. References: [1]Gladman DD, Ziouzina O, Thavaneswaran A, Chandran V. Dactylitis in psoriatic arthritis: prevalence and response to therapy in the biologic era. J Rheumatol. 2013;40:1357-9. Disclosure of Interests: None declared