O025 - CHRONIC INTESTINAL FAILURE IN SYSTEMIC SCLEROSIS : CLINICAL FEATURES, OUTCOMES AND PROGNOSTIC FACTORS FROM A FRENCH MULTICENTER COHORT.

O025

CHRONIC INTESTINAL FAILURE IN SYSTEMIC SCLEROSIS : CLINICAL FEATURES, OUTCOMES AND PROGNOSTIC FACTORS FROM A FRENCH MULTICENTER COHORT.

J. CHABAUD-SASSOULAS^1,*, F. JOLY², T. DUFORT³, C. BERGOIN⁴, M. BARRAUD-BLANC⁵, C. JOUBERT⁶, M. VALLEE⁶, A. JIRKA⁷, P. FAYEMENDY⁸, R. THIBAULT⁹, D. SEGUY¹⁰, N. FLORI¹¹, E. FONTAINE¹², M.-E. TRUCHETET³, F. POULLENOT¹

¹Service de Gastroentérologie et assistance nutritive, Hopital Haut Lévêque, CHU Bordeaux, Bordeaux, ²MICI et assistance nutritive, Hopital Beaujon, Clichy, ³EUSTAR, (European Scleroderma Trials and Research group), European Network for Systemic Sclerosis; ImmunoConcept, UMR CNRS 5164, CHU Bordeaux, Bordeaux, ⁴Service d’Hépato-Gastro-Entérologie et Assistance Nutritionnelle, Hopital Lyon Sud, Oullins, ⁵Unité d’Hépato-gastroentérologie et nutrition artificielle, Hôpital de la Timone, Marseille, ⁶Unité transversale de nutrition clinique, Tour Côte de Nacre, CHU de Normandie, Caen, ⁷Unité d’Hépato-gastroentérologie, Hôtel-Dieu, CHU de Nantes, Nantes, ⁸Service d’Hépato-gastro-entérologie et Nutrition, Hôpital Dupuytren, CHU de Limoges, Limoges, ⁹Centre de référence Maladies Digestives Rares (MaRDi), CHU de Rennes, Rennes, ¹⁰Service Diabétologie Nutrition, CHU de Lille, Lille, ¹¹Service de Gastroentérologie, Institut du cancer de Montpellier, Hôpital Lapeyronie, Montpellier, ¹²Unité transversale de nutrition, Hôpital Michallon, CHU de Grenoble, La tronche, France

Rationale: Gastrointestinal involvement in systemic sclerosis (SSc) may progress to chronic intestinal failure (CIF), requiring long-term parenteral nutrition (PN). However, data on the prognosis of these patients and the factors influencing survival remain scarce.

Methods: We conducted a retrospective multicenter study across 11 French PN centers between 2017 and 2025. Eighty-three adults with SSc or Sharp’s syndrome fulfilling ESPEN CIF criteria and requiring PN and/or IV hydration were included. Clinical, nutritional, and treatment-related data were collected. Survival was assessed using Kaplan–Meier analysis and Cox proportional hazards models.

Results: The cohort comprised 83% women, with diffuse (45%) and limited (43%) cutaneous forms. At PN initiation, patients were severely malnourished, with a median BMI of 17.2 kg/m² and a median weight loss of 24%; micronutrient deficiencies were common. Catheter-related bloodstream infection occurred in 61% of patients and heart failure in 18%. After a median follow-up of 5.5 years, 40% of patients had died, mainly from gastrointestinal complications, PN-related events, or cardiopulmonary causes. In multivariable analysis, male sex was strongly associated with mortality (HR 4.49, 90% CI 2.37–8.53, p<0.001). Conversely, weight gain during PN, observed in 73 % of patients was associated with improved survival (HR 0.33, 90% CI 0.16–0.66, p=0.009). Cardiac decompensation emerged as the strongest predictor of mortality (OR 10.8, 90% CI 3.3–35.8, p=0.002).

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Conclusion: In SSc-CIF patients requiring PN, long-term mortality remains high. Male sex and cardiac decompensation predict higher risk, while weight gain during PN improves survival. These results support proactive nutritional care and systematic cardiac monitoring, and encourage targeted cardio-nutritional strategies in future studies.

Disclosure of Interest: None declared