OP0289 PREVALENCE OF ANTI-RO52-KDA/SSA (TRIM21) ANTIBODIES AND ASSOCIATED CLINICAL PHENOTYPE IN SYSTEMIC SCLEROSIS: DATA FROM A FRENCH COHORT, A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: M. E. Martel, A. Leurs, D. Launay, H. Béhal, A. Chepy, A. Collet, S. Sanges, E. Hachulla, S. Dubucquoi, L. Dauchet, V. Sobanski
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Anti-Ro52-kDa/SSA (TRIM21) antibodies are increasingly reported in systemic sclerosis (SSc), with heterogenous results both in prevalence and clinical significance [1], thus preventing a clear understanding of their implication in patients care. <h3>Objectives:</h3> To estimate the global prevalence of anti-TRIM21 antibodies in SSc, and describe the associated clinical phenotype, through a systematic review and meta-analysis of published reports and new data from our French cohort. <h3>Methods:</h3> Anti-TRIM21 seropositivity and associated SSc characteristics were assessed in a cross-sectional study including 300 patients of Lille University Hospital. A systematic review of the literature was performed in Pubmed and Embase, followed by a meta-analysis, using data on prevalence, clinical/demographical/biological characteristics of SSc patients and the type of assay used for anti-TRIM21 antibodies detection. <h3>Results:</h3> In the cross-sectional study, anti-TRIM21 antibodies prevalence was 26.0% [95% CI: 21.1; 31.3]. Anti-centromere antibodies were the most frequent SSc specific autoantibodies coexisting with anti-TRIM21. Patients with anti-TRIM21 antibodies were more frequently women (91% vs 77%, p = 0.006), more likely to present an associated Sjögren's syndrome (31% vs 11%, p&lt;0.001), had a higher rate of pulmonary arterial hypertension (PAH) (21% vs 9%, p = 0.017) and a greater frequency of digestive complications such as dysphagia (20% vs 9%, p = 0.038) or nausea/vomiting (18% vs 5%, p = 0.009) than anti-TRIM21 negative patients. Thirty-five articles corresponding to a total of 11,751 SSc patients were included in the meta-analysis. In this population, the overall seroprevalence of anti-TRIM21 antibodies was 23% [95%CI: 21-27%] with a high degree of heterogeneity (I<sup>2</sup>: 93% Phet: &lt;0.0001), partly explained by the methods of detection (Figure 1). Anti-TRIM21 seropositivity was positively associated with female sex (OR: 1.60 [1.25, 2.06]), limited cutaneous subset (OR: 1.29 [1.04, 1.61]), joint manifestations (OR: 1.33 [1.05, 1.68]), pulmonary hypertension (PH) (OR: 1.82 [1.42, 2.33]), and interstitial lung disease (ILD) (OR: 1.31 [1.07, 1.60]). <h3>Conclusion:</h3> Anti-TRIM21 antibodies frequently co-exist with usual SSc antibodies but are independently associated to a higher risk of cardio-pulmonary complications. The presence of these autoantibodies should therefore be considered when assessing the risk of developing PH and ILD, and deserves further studies on appropriate screening and follow-up of patients. <h3>REFERENCES:</h3> [1] Decker P, Moulinet T, Pontille F, <i>et al.</i> An updated review of anti-Ro52 (TRIM21) antibodies impact in connective tissue diseases clinical management. <i>Autoimmun Rev</i>. 2022;21:103013. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Marie-Elise Martel: None declared, Amelie LEURS CSL Vifor and NOVARTIS, outside the submitted work, David Launay Takeda, Biocryst and CSL Behring, outside the submitted work, GSK, Octapharma, Pfizer, Takeda, Biocryst, CSL Behring, outside the submitted work, Hélène Béhal: None declared, Aurélien Chepy: None declared, Aurore Collet: None declared, Sebastien SANGES: None declared, Eric Hachulla: None declared, Sylvain Dubucquoi: None declared, Luc Dauchet Feder Ecrin and ADEM French environment agency outside the submitted work, Vincent Sobanski Boehringer-Ingelheim, Grifols, Ultragenyx, outside the submitted work, Grifols, outside the submitted work.