FRI0379 Inflammatory joint involvement is associated with severe dry eye in patients with primary sjÖgren’s syndrome
Authors: M. Fernandez Castro, C. Sanchez-Piedra, J.L. Andreu, V. Martínez Taboada, A. Olive, J. Rosas
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Primary Sjögren’s syndrome (pSS) is characterised by lymphocytic infiltration of exocrine glands and other organs, resulting in dry eye, dry mouth and extraglandular systemic involvement such as pain, mialgia or polyarthralgia, among others. <h3>Objectives</h3> The aim of the present study is to explore the association of severe or very severe dry eye with extraocular involvement in patients with pSS. <h3>Methods</h3> SJOGRE-SER registry is a multicenter cross-sectional study of pSS patients fulfilling European/American consensus criteria 2002 from 33 Spanish rheumatology departments. Data were collected by reviewing clinical records and interviewing patients. For the construction of our main variable, “severe/very sever dry eye” (S/VSDE), we used those variables present in our cohort that represented a degree 3–4 of severity (S/VSDE) according to the dry eye TFOS DEWS I classification 2007 (Tear Film and Ocular Surface Society Dry Eye Work-Shop): Schirmer score (≤5 mm/5 min) and/or corneal ulcers and/or use of autologous sera and/or contact lenses and/or Stenon conduit bypass and/or palpebral cleft reduction. First, bivariate logistic regression models were used to identify the effect of each independent variable on S/VSDE. Secondly, multivariate analysis using regression model was used to establish the independent effect of patient characteristics associated with the dependent variable. <h3>Results</h3> Four hundred and thirty-seven patients were included in SJOGREN-SER registry (female gender 95%; median age 58 (50.02–67.98) years). Mean time of evolution of the disease in the cohort was 8.3 years. ESSDAI mean score was 2 (0–4, P25-P75) in the full registry. Ninety-four per cent of the patients in SJOGREN-SER cohort complained of daily, persistent, troublesome dry eyes, 92% had sensation of sand in the eyes and 16% developed corneal ulcer. In the full cohort Schirmer’s test was performed in 402 patients and was pathological (≤5 mm/5 min) in 371 patients (92%). The use of autologous sera was 14%, contact lenses 2%, Stenon conduit bypass 0.23% and palpebral cleft reduction 0.23%. Three hundred and seventy-eight patients (86.5%) presented S/VSDE; 95% were women, and the median age was years. Mean time of evolution of the disease was 8.51 and ESSDAI mean score was 5. Inflammatory articular involvement was significantly more frequent in patients with S/VSDE (82.5%) than in those without S/VSDE (69.5%) (p=0,028). Inflammatory joint affectation was associated with S/VSDE in the multivariate analysis, OR 2.079 (95% CI, 1.096–3.941). These results were adjusted by sex, age, time of evolution of the disease and ESSDAI score. <h3>Conclusions</h3> Severe or very severe ocular involvement is associated with the presence of inflammatory joint involvement in patients with pSS. These results suggest that a directed anamnesis including systemic comorbidities, such as the presence of inflammatory joint affectation and dry mouth, in patients with severe dry eye, would be useful to suspect an pSS. <h3>Reference</h3> [1] Report of the International Dry Eye Workshop (DEWS). Ocul Surf2007;5:65. <h3>Disclosure of Interest</h3> None declared