AB0460 USE OF PLATELET RICH PLASMA (PRP) IN TREATMENT OF DRY EYE SYNDROME IN THE PATIENTS WITH SJÖGREN SYNDROME: PRELIMINARY RESULTS
Authors: Annunziata Capacci, Francesco Ricci, Valentina Varriano, Barbara Tolusso, Pietro Rubortone, Anna Maria Paglionico, Antonio Ciardiello, Stefano Alivernini, Gianfranco Ferraccioli, Elisa Gremese
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Xeroftalmia and xerostomia are the hinge symptoms of Sjögren Syndrome and often they negatively influence patients' quality of life. The eyewashes use based on Platelet Rich Plasma (PRP) has been applicate in the treatment of the xeroftalmia, both primitive and secondary. <h3>Objectives:</h3> To evaluate the effect of subconjunctival injections and PRP based eyewashes on the ocular dryness (subjective and objective) in patients suffering of primary Sjögren syndrome (pSS). <h3>Methods:</h3> Six pSS patients (6 females, age at the beginning 48.2±9.7 years) have been recruited in the study. All patients were reaching the criteria for pSS diagnosis; for each patient clinical and immunological data have been recorded. Patients with Schirmer Test value, in at least an eye, inferior to 10 mm after 5 minutes, and suffering from severe dryness calculated by OSDI score (between 33 and 100, severe condition of dry eye) in spite of therapies with tear substitutes were selected. The OSDI (Ocular Surface Index) is a questionnaire for the evaluation of the subjective ocular dryness. Selected patients have been addressed to treatment with PRP. The PRP is constituted by human plasma enriched with plaques by means of the utilisation of a special kit, therefore each patient has been subjected to a blood drawing, from which PRP has been extracted. Of this, a part has been injected in subconjunctival seat; from remained one, an eyewash has been extracted that the patients have assumed 6 times in the day up to exhaustion (about 5 days) during which another topic therapy was not used. The patients have been valued to the basal time and after ten days of the procedure; besides follow-up visits each three months are scheduled. To each evaluation Schirmer Test data and OSDI have been checked. <h3>Results:</h3> Each patient had severe xeroftalmy, evaluated by Schirmer Test (right Eye: 3.33±2.66; left eye: 6.83±6.5) and index OSDI (59.71±20.72). All the patients had Schirmer Test values, in at least an eye, lesser than 10 mm after 5 minutes. The analized cohort had homogeneous clinical characteristics (presence of xerostomy and absence of inflammatory indexes, hypergammaglobulinemia, arthritis and linfoadenomegaly). After one week (T1), OSDI values were significantly more reduced compared to the basal time (38.89±15.12; p=0.028). The Schirmer Test values were not significative different to the follow-up visit compared to the basal one. No patients presented pre- and post-procedural complications, neither related infectious events. At 3 months follow up after first treatment (T2) no statistically significant difference in OD/OS Schirmer test values and OSDI score compared to the basal time were observed. <h3>Conclusion:</h3> The use of PRP in dry eye syndrome in patients with Sjögren syndrome seems to be effective in alleviating symptoms and improving patients' life quality. Is need further follow-up to confirm data, to value effect also on the objective tests and to evaluate necessity of repeating treatment. <h3>References</h3> [1] ShiboskiSC;Arthritis Care Res, 2012; 64(4): 475–487 [2] AlioJ; OphtalmicResearch, 2017; 39: 124–129 [3] AlioJ; CurrPharm Biotech, 2012; 13: 1257-1265 <h3>Disclosure of Interests:</h3> Annunziata Capacci: None declared, Francesco Ricci: None declared, Valentina Varriano: None declared, Barbara Tolusso: None declared, Pietro Rubortone: None declared, Anna Maria Paglionico: None declared, Antonio Ciardiello: None declared, Stefano Alivernini Speakers bureau: BMS, Gianfranco Ferraccioli Speakers bureau: BMS, Roche, Elisa Gremese Consultant for: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Sanofi, UCB, Roche, and Pfizer, Speakers bureau: BMS, Speakers bureau: Roche, Speakers bureau: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Sanofi, UCB, Roche, and Pfizer