SAT0233 CHARACTERISTICS OF PRIMARY SJÖGREN’S SYNDROME INCLUDING ULTRASOUND FINDINGS OF THE SALIVARY GLANDS, ESSDAI AND ESSPRI

Abstract

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 (%)Women46 (95.8)Age, mean (95%CI)60 (57-62)Smoking, n (%)Smoker1 (2.1)BMI, n (%)< 18.55 (10.4)18.5 – 24.920 (41.7)25.0 – 29.912 (25.0)30.0 – 34.910 (20.8)> 35.01 (2.1)Serologic markers, n (%)SSa positive33 (68.8)SSb positive22 (45.8)ANA positive38 (79.2)Cryoglobulin positive9 (18.8)ESSPRI 0-10, mean (95%CI)Dryness7.3 (6.7-7.9)Fatigue7.1 (6.4-7.7)Pain5.9 (5.1-6.7)SGUS, n (%)Score 06 (12.5)Score 115 (31.3)Score 213 (27.1)Score 314 (29.2)ESSDAI, n (%)ESSDAI < 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.