AB0538 INFLUENCE OF IMMUNOLOGICAL FEATURES, DISEASE ACTIVITY AND FATIGUE ON THE HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH PRIMARY SJOGREN’S SYNDROME
Authors: Rada Miskovic, Aleksandra Plavsic, Maja Stojanovic, Zikica Jovicic, Aleksandra Peric Popadic, Vesna Tomic Spiric, Sanvila Raskovic
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Studies show that the health-related quality of life (HRQoL) is significantly reduced in patients with primary Sjogren's syndrome (pSS). However, potential predictors of HRQoL in these patients are not well known. <h3>Objectives:</h3> To investigate potential influence of main immunological features, fatigue and disease activity on the HRQoL in patients with pSS. <h3>Methods:</h3> We studied 41 consecutive in- and outpatients with pSS diagnosed according to the AECG criteria in the Clinic of Allergy and Immunology. The SF-36 questionnaire has been used to assess HRQoL. The SF-36 values have been compared with the population based reference values. Fatigue was assessed using Fatigue Severity Scale (FSS). ESSDAI was used for the evaluation of systemic involvement and disease activity and ESSPRI for the evaluation of the patient-reported outcomes. <h3>Results:</h3> There were 38/41 female patients. The mean age was 56.2 ±13.5 years and the mean disease duration was 3.9 ±5.8 years. HRQoL was reduced in almost all SF-36 domains in the comparison to healthy population: physical functioning (PF) (p=0.0161); role physical (RP) (p=0.0005); social functioning (SF) (p=0.0234); role emotional (RE) (p=0.0421). The mean value of FSS score was 4.6±2.2, with 53.6% of patients having FSS score more than 4.8 (which is considered to be pathological). There were no significant differences in HRQoL depending on the presence of ANA (p=0.44), anti-SSA Abs (p=0.0756), anti-SSB Abs (p=0.218), cryoglobulins (p=0.8), complement consumption (p=0.122). Patients with elevated values of RF had significantly higher HRQoL (p=0.00453). Serum IgG concentrations positively correlated with HRQoL (rho=0.488, p=0.00139), and especially with the domains of SF (rho=0.502, p=0.0005) and PF (rho=0.491, p=0.00129). We found a significant negative correlation between HRQoL and FSS score (rho=-0.794, p&lt;0.001). The mean ESSDAI score was 3.8 (0-23), and 75.6% of patients had some level of disease activity according to ESSDAI. Patients with low disease activity had higher HRQoL compared to those with moderate disease activity in following SF-36 domains: physical composite score (PCS) (p=0.0148), PF (p=0.0328), RP (p=0.00697) and vitality (VT) (p=0.05). The mean ESSPRI score value was 5.1±2.7 (dryness scale – 6.1, fatigue scale - 5.4, limb pain scale – 3.8). ESSPRI score negatively correlated with HRQoL (rho=-0.763, p&lt;0.001) in all SF-36 domains. <h3>Conclusion:</h3> Our study identified ESSDAI, ESSPRI and FFS scores, serum RF and IgG concentrations as potential predictors of HRQoL in patients with pSS. <h3>References</h3> [1] Ibn Yacoub Y, Rostom S, Laatris A, Hajjaj-Hassouni N (2012) Primary Sjogren's syndrome in Marroccan patients: characteristics, fatigue and quality of life. Rheumatol Int 32:2637-43. [2] Chou A, Gonzales JA, Daniels TE, et al. (2017) Health-related quality of life and depression among participants in the Sjogren's International Collaborative Clinical Alliance registry. RMD Open 3:e000495. [3] Seror R, Bootsma H, Saraux A, et al. (2016) Defining disease activity states and clinically meaningful improvement in primary Sjogren's syndrome with EULAR primary Sjogren's syndrome disease activity (ESSDAI) and patient-reported indexes (ESSPRI). Ann Rheum Dis 75:382-389. [4] Cho HJ, Yoo JJ, Yun CY, et al. (2013) The EULAR Sjogren's syndrome patient reported index as an independent determinant of health-related quality of life in primary Sjogren's syndrome patients: in comparison with non-Sjogren's sicca patients. Rheumatology 52:2208-2217. <h3>Disclosure of Interests:</h3> None declared