AB0418 APPLICATION OF ACR (2012), ACR/EULAR (2016) AND RUSSIAN (2001) CRITERIA FOR PRIMARY SJÖGREN’S SYNDROME ON RUSSIAN COHORT OF PATIENTS
Authors: J. Khvan, S. Palshina, V. Vasiliev, A. Torgashina, E. Sokol, B. Chaltcev
Journal: Annals of the Rheumatic Diseases (2020)

Background: Over the past few years new international criteria have been proposed for the classification of primary Sjögren’s syndrome (pSS) from the American College of Rheumatology (ACR) in 2012 and the ACR with European League Against Rheumatism (ACR/EULAR) in 2016 [1, 2]. In real practice in Russia we use Russian criteria (2001). Objectives: To estimate ACR (2012) and ACR/EULAR (2016) criteria in Russian cohort of patients with pSS patients fulfilling Russian criteria (2001). Methods: From 2016 to 2019 we examined 110 patients (109 female, 1 male) with newly diagnosed pSS fulfilling Russian criteria with the mean age 50,2±14 years (min 18; max 82). Russian criteria for pSS: I) keratoconjunctivitis sicca (stimulated Schirmer’s test &lt;10 mm/5 min or fluorescein staining of the cornea or tear break-up time &lt; 10 sec); II) sialadenitis (sialectasia on parotid sialography (obligatory) +/- stimulated saliva flow test&lt;2,5 ml/ 5min +/- labial salivary gland biopsy with focus score (FS) of ≥2 foci/4mm 2 ); III) positive antinuclear antibody (ANA) or positive ANA with rheumatoid factor (RF) or anti-SSA (anti-Ro) or/and SSB (anti-La). According it pSS is verified if the first two criteria and at least one of the immunological criteria are presented. We evaluated clinical, laboratory and instrumental features (table 1). Table 1. Characteristics of Russian cohort of patients with primary Sjögren’s syndrome (n = 110) Parameters Patients (n / % ) ocular dryness 76 (69%) oral dryness 88 (80%) anti-SSA (anti-Ro) positive (&gt;25 IU/ml) 93 (84.5%) anti-SSB (anti-La) positive (&gt;25 IU/ml) 57 (51.8%) RF positive &gt;2UNL (&gt;30 IU/ml) 68 (61.8%) ANA ≥1:320 110 (100%) (stimulated) Schirmer’s test (≤5 mm/5 minutes) 55 (50%) stimulated SFT &lt;2,5ml/5 min 77 (70%) OSS ≥5 28 (25.4%) OSS ≥3 43 (39%) FS ≥ 1foci/4 mm 2 99 (90%) Sialectasia on parotid sialography 110 (100%) In our cohort according to Russian criteria (2001) 94 patients (86%) fulfilled ACR (2012) criteria, 86 (78%) - ACR/EULAR (2016) criteria. Results: In our cohort, 20-30% of patients, according to Russian criteria did not complain of oral or ocular dryness. In 61% of patients, mild eye damage was detected (OSS&lt;3-5), and in half of the cases, the stimulated Schirmer’s test was more than 5.0 mm, but less than 10 mm/5 minutes, while 69% of patients complained of dry eyes. Most patients (84.5%) had positive anti-Ro, just over half (51.8%) had anti-La. All patients had sialectasia of various stages on parotid sialography. Less than 1 FS was detected in 10% of patients. Conclusion: Using Russian criteria (2001), we can identify pSS at an early stage. Our criteria inclusion complex examination in which an immunological sign must be present to confirm the diagnosis. Patients with pSS according to ACR (2012) and/or ACR/EULAR (2016) criteria seem to be diagnosed without specific antibodies and on the more progressive disease stages. References: [1]SC Shiboski, CH Shiboski, LA Criswell, AN Baer, S Challacombe, H Lanfranchi, M Schiødt, H Umehara, F Vivino, Y Zhao, Y Dong, D Greenspan, AM Heidenreich, P Helin, B Kirkham, K Kitagawa, G Larkin, M Li, T Lietman, J Lindegaard, N McNamara, K Sack, P Shirlaw, S Sugai, C Vollenweider, J Whitcher, A Wu, S Zhang, W Zhang, JS Greenspan, and TE Daniels for the Sjögren’s International Collaborative Clinical Alliance (SICCA) Research Groups. American College of Rheumatology Classification Criteria for Sjögren’s Syndrome: A Data-Driven, Expert Consensus Approach in the SICCA Cohort. [2]Caroline H. Shiboski,1 Stephen C. Shiboski,1 Raphae `le Seror,2 Lindsey A. Criswell,1 Marc Labetoulle,2 Thomas M. Lietman,1 Astrid Rasmussen,3 Hal Scofield,4 Claudio Vitali,5 Simon J. Bowman,6 Xavier Mariette,2 and the International Sjogren’s Syndrome Criteria Working Group. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjogren’s Syndrome. ARTHRITIS &amp; RHEUMATOLOGY Vol. 00, No. 00, Month 2016, pp 00–00 DOI 10.1002/art.39859. Disclosure of Interests: : None declared