SAT0060 OVERLAPPING SJOGREN’S SYNDROME REDUCES THE PROBABILITY OF REACHING TARGET IN RHEUMATOID ARTHRITIS PATIENTS: A PROPENSITY SCORE MATCHED REAL-WORLD COHORT FROM 2009 TO 2019

Abstract

Background:Overlapping Sjogren’s syndrome (SS) is not uncommon in rheumatoid arthritis (RA), and considered as a probable detrimental factor of RA. But data on the impact of overlapping SS on RA therapeutic response is limited.Objectives:Our current study aimed to identify the effect in a real-world cohort from 2009 to 2019.Methods:The medical records of RA patients who attended the outpatient department of our medical center from 2009 to 2019 were reviewed, and the disease activity based on DAS28-ESR, DAS28-CRP, SDAI and CDAI at each follow-up point were collected. To correct confounders which may affect the therapeutic response between those RA patients with SS (RA-SS) and without (RA-noSS), we compared both the propensity score-matched and unmatched cohorts using the Cox proportional hazards model.Results:Among the 1099 RA patients, 129 (11.7%) overlapped with SS validated by positive anti-SSA or pathological minor salivary gland biopsy (MSGB). After propensity score matching based on their baseline characteristics, 126 of 129 RA-SS and 126 of 970 RA-noSS patients were statistically extracted. Overlapping SS was associated with a 29%, 26%, 18%, 22% lower probability of reaching remission in RA patients based on DAS28-ESR, DAS28-CRP, SDAI, CDAI, respectively, which trend kept true for reaching low disease activity (LDA) either. Although overlapping SS had the most significant impact on ESR (HR 0.69, 95%CI 0.61-0.79), other components assessing RA disease activity were also in jeopardy. When stratified by age, RA duration, RF and ACPA status, baseline DAS28-CRP, the trend remained.Conclusion:Overlapping SS is associated with a lower probability of reaching target in RA patients, and should be regarded as one of the poor prognostic factors in the management of RA.TableHazard Ratios for Reaching Remission/Low disease activity and Individual Components in RA patients Associated with Overlapping SSUnmatched cohort(n=1099)Matched cohort(n=252)Trimmed cohort(n=242)Remission Based on Composite Disease Activity ScoreDAS28-ESR0.68 (0.62, 0.75)0.71 (0.62, 0.82)0.74 (0.64, 0.85)DAS28-CRP0.80 (0.74, 0.87)0.74 (0.66, 0.83)0.74 (0.66, 0.83)SDAI0.82 (0.74, 0.91)0.82 (0.70, 0.94)0.83 (0.72, 0.97)CDAI0.77 (0.70, 0.86)0.78 (0.67, 0.91)0.78 (0.67, 0.91)Boolean0.83 (0.75, 0.92)0.80 (0.69, 0.93)0.82 (0.70, 0.95)Remission/LDA Based on Composite Disease Activity ScoreDAS28-ESR0.76 (0.70, 0.82)0.73 (0.65, 0.82)0.74 (0.66, 0.83)DAS28-CRP0.80 (0.74, 0.86)0.76 (0.68, 0.84)0.75 (0.68, 0.84)SDAI0.79 (0.73, 0.85)0.74 (0.66, 0.82)0.74 (0.66, 0.82)CDAI0.78 (0.73, 0.84)0.74 (0.66, 0.82)0.74 (0.66, 0.82)Individual Components of Disease Activity Score28SJC≤10.83 (0.77, 0.89)0.77 (0.69, 0.85)0.76 (0.68, 0.84)28TJC≤10.81 (0.75, 0.87)0.79 (0.70, 0.88)0.78 (0.70, 0.88)PtGA≤10.81 (0.74, 0.89)0.82 (0.71, 0.94)0.82 (0.72, 0.95)PrGA≤10.81 (0.74, 0.88)0.78 (0.69, 0.88)0.79 (0.70, 0.89)ESR≤ULN0.66 (0.61, 0.73)0.69 (0.61, 0.79)0.74 (0.65, 0.84)CRP≤1mg/dL0.84 (0.78, 0.90)0.76 (0.68, 0.84)0.77 (0.69, 0.85)Disclosure of Interests:None declared