SAT0233 CHARACTERISTICS OF PRIMARY SJÖGREN’S SYNDROME INCLUDING ULTRASOUND FINDINGS OF THE SALIVARY GLANDS, ESSDAI AND ESSPRI
Authors: N. S. Schmidt, A. Voss, S. A. Just, H. M. Lindegaard
Journal: Annals of the Rheumatic Diseases (2020)

Background: Studies have shown that salivary gland ultrasonography (SGUS) may have a potential value in the diagnosis of Sjogren’s Syndrome (SS). Knowledge of the association between ultrasonography findings, disease activity and damage, serologic markers and patient report outcome is limited. Objectives: To investigate whether the results of SGUS are associated with disease manifestations and damage measured by doctor-reported activity score index (ESSDAI) and serologic markers. Furthermore to investigate the contribution of patient reported outcome measure (ESSPRI) in disease monitoring. Methods: Patients registered at Odense University Hospital with the diagnosis primary SS were included in a Danish cohort. The patients were characterized using the ESSDAI, ESSPRI, serologic markers and SGUS-findings in submandibular and parotid glands. Schirmer’s test and salivary test were performed for measurement of tear and salivary production. SGUS was performed using a linear transducer, Siemens (ACUSON Sequoia Ultrasound System) on the two parotid and two submandibular glands. SGUS images was scored according to the OMERACT SS severity scoring system from 0 to 3, where 2 is moderate and 3 severe(1). A reliability study was performed in advance of the present study. Spearman´s r correlation coefficient was used to assess correlation between scores. Results: The cohort consisted of 48 Caucasian patients diagnosed with primary SS. Details on patient characteristics are shown in table 1. Table 1. Sex , n (%) Women 46 (95.8) Age , mean (95%CI) 60 (57-62) Smoking , n (%) Smoker 1 (2.1) BMI , n (%) &lt; 18.5 5 (10.4) 18.5 – 24.9 20 (41.7) 25.0 – 29.9 12 (25.0) 30.0 – 34.9 10 (20.8) &gt; 35.0 1 (2.1) Serologic markers , n (%) SSa positive 33 (68.8) SSb positive 22 (45.8) ANA positive 38 (79.2) Cryoglobulin positive 9 (18.8) ESSPRI 0-10 , mean (95%CI) Dryness 7.3 (6.7-7.9) Fatigue 7.1 (6.4-7.7) Pain 5.9 (5.1-6.7) SGUS , n (%) Score 0 6 (12.5) Score 1 15 (31.3) Score 2 13 (27.1) Score 3 14 (29.2) ESSDAI , n (%) ESSDAI &lt; 5 (low-activity) 22 (45.8) ≤ 5 ESSDAI ≤ 13 (moderate-activity) ESSDAI ≥ 17 (35.4) 14 (high-activity) 9 (18.8) The correlation between ESSDAI-scores and SGUS-scores was r = 0.153 (p = 0.299). The correlation between ESSDAI-scores and ESSPRI-scores (dryness, fatique, pain) was r = 0.071 (p = 0.632), r = 0.254 (p = 0.082) and r = -0.002 (p = 0.987). The correlation between SGUS-scores and ESSPRI-scores (dryness, fatique, pain) was r = 0.124 (p = 0.400), r = -0.292 (p = 0.044) and r = -0.459 (p = 0.001). Conclusion: In a Danish cohort of SS most patients had SSa and ANA autoantibodies. SGUS demonstrated high damage (score 2-3) in approximately half of the patients. ESSDAI activity score did not correlate with SGUS damage scores or the ESSPRI. SGUS damage scores correlated with ESSPRI-scores of fatique and pain, but not dryness. Associations between other factors of importance for damage and SGUS scores are to be analyzed. SGUS and the ESSPRI describe different SS-related dimensions and will probably contribute in disease monitoring in the future. References: [1]Jousse-Joulin S, D’Agostino MA, Nicolas C, Naredo E, Ohrndorf S, Backhaus M, et al. Video clip assessment of a salivary gland ultrasound scoring system in Sjogren’s syndrome using consensual definitions: an OMERACT ultrasound working group reliability exercise. Annals of the rheumatic diseases. 2019;78(7):967-73. Disclosure of Interests: None declared