POS1266 THE EFFECTS OF IMMUNOSUPRESSIVE THERAPY ON GLANDULAR INVOLVEMENT IN PATIENTS WITH PRIMARY SJÖGREN’S SYNDROME
Authors: S. Gunay, E. Sevimli, G. Mumcu, N. Inanc
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Primary Sjögren's Syndrome (pSS) is characterized by reduced glandular function mainly due to the infiltration of lymphocytes and following destruction of glandular tissue [1]. Unstimulated whole salivary flow rate (U-WSFR) and stimulated whole salivary flow rate (S-WSFR) are essential indicators of salivary gland function [2, 3]. This study aimed to assess the impact of immunosuppressive (IS) therapy on glandular function in patients with pSS. <h3>Methods:</h3> Seventy-five patients diagnosed as pSS according to 2016 ACR/EULAR classification criteria [4] were included in this retrospective study (F/M: 71/4; mean age: 53.20±11.14 yrs). They were divided into three groups based on their use of immunosuppressive (IS) treatment protocols such as "Intermittent IS use" (n=10; %13,3), "Long-term IS use" (n=36; %48) and "No need to use IS" (Non-IS; n=29; %38,7). Salivary flow rates of patients were measured at their last visits. Then, patients were grouped whether hyposalivation was present (n=29; %38,7) or not (n=46; %61,3) according to the U-WSFRs (≤0.1 ml/min) [5, 6]. Comorbidities, serologic and clinical features of the patients were also recorded from patients' files retrospectively. <h3>Results:</h3> In the study group, durations for IS use were 41,44±36,95 months for "Intermittent IS use" group and 79,69±72,01 months for "Long-term IS use" group. Lung and Renal involvement rates were observed to be 19,4% (n=7) and 25% (n=9) in the "Long-term IS use" group, while frequency of arthritis was observed to be 70% (n=7) in "Intermittent IS use" group. However, no significant difference was found according to age, smoking status, diabetes mellitus and SS-A positivity among groups (p&gt;0.05). The ratio of Hyposalivation (≤0,1 ml/min) was higher in Non-IS group (52%) than that of "Intermittent IS use" group (25%) (p=0.056). Elevated U-WSFR and S-WSFR were observed in patients who were in "Long-term IS use" group (0,24±0,18 ml/min. and 1.04±0,69 ml/min, respectively), compared to those of "Intermittent IS use" (0,20±0,31 ml/min and 0,54±0,41 ml/min, respectively)(p=0.038; p=0.069) and Patients treated with Non-IS medications (0,14±0,15 ml/min and 0,20±0,31 ml/min) (p=0.009; p=0.025). <h3>Conclusion:</h3> In the limits of the study, "Long-term IS use" could have positive effects on protecting salivary gland functions in patients with pSS. <h3>REFERENCES:</h3> [1] Ramos-Casals, M., et al., <i>EULAR recommendations for the management of Sjogren's syndrome with topical and systemic therapies.</i> Ann Rheum Dis, 2020. <b>79</b>(1): p. 3-18. [2] Rosas, J., et al., <i>Usefulness of basal and pilocarpine-stimulated salivary flow in primary Sjogren's syndrome. Correlation with clinical, immunological and histological features.</i> Rheumatology (Oxford), 2002. <b>41</b>(6): p. 670-5. [3] Shiboski, C.H., et al., <i>2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjogren's Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts.</i> Arthritis Rheumatol, 2017. <b>69</b>(1): p. 35-45. [4] Vitali, C. and N. Del Papa, <i>Classification and diagnostic criteria in Sjogren's syndrome: a long-standing and still open controversy.</i> Ann Rheum Dis, 2017. <b>76</b>(12): p. 1953-1954. [5] Inanc, N., et al., <i>Evaluation of salivary gland ultrasonography in primary Sjogren's syndrome: does it reflect clinical activity and outcome of the disease?</i> Clin Exp Rheumatol, 2019. <b>37 Suppl 118</b>(3): p. 140-145. [6] Moritsuka, M., et al., <i>Quantitative assessment for stimulated saliva flow rate and buffering capacity in relation to different ages.</i> J Dent, 2006. <b>34</b>(9): p. 716-20. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>