Do Primary Sjögren’s Syndrome Patients with Normal Major Salivary Gland Ultrasound Have Less Active Disease?

Katja Perdan Pirkmajer¹, Matija TOMSIC¹ and Alojzija Hocevar², ¹University Medical Centre Ljubljana, Ljubljana, Slovenia, ²UKC Ljubjana, Ljubjana, Slovenia

Meeting: ACR Convergence 2021

Keywords: Sjögren's syndrome, Ultrasound

Session Information

Date: Saturday, November 6, 2021

Title: Sjögren's Syndrome – Basic & Clinical Science Poster (0296–0322)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: Ultrasonographically depicted morphological changes of major salivary glands (SG) have been recently correlated with the disease activity in primary Sjögren’s (pSS)¹. The aim of our prospective, cross-sectional study was to determine whether pSS patients with normal SG ultrasound indeed have less active disease at baseline.

Methods: We included 129 consecutive adult pSS patients, diagnosed at our secondary – tertiary center between 2017-2019. All patients fulfilled the 2016 ACR/EULAR classification criteria² and underwent a routine diagnostic procedure including major SG ultrasound³ and minor SG biopsy. Disease activity was assessed with ESSDAI⁴. Multivariate logistic regression was used to evaluate factors predicting baseline ESSDAI.

Results: Our pSS cohort consisted of 120 females and 9 males, with a median (IQR) age 62 (51-69) years, and median (IQR) symptom duration of 24 (10-41) months. Among them 95 (73.6 %) had antinuclear antibodies, 98 (76.0%) anti-SSA, 21 (16.3%) had anti-SSB, and 37 (28.6%) had rheumatoid factor (RF), respectively. Four patients had anticentromere antibodies. Twenty-nine (22.5%) patients had 3 or more different autoantibodies. Minor salivary gland biopsy was positive in 83 (64%) patients. Forty-nine patients (38.0%) had a positive major SG ultrasound. Median (IQR) ESSDAI was 2 (0-6), range 0-34 at baseline. Among the ESSDAI components articular and biological component predominated (Figure 1). Using multivariate analysis, we found no association between baseline ESSDAI, and SG US changes, histological focus score, the number of antibodies, patients’ age, sex, symptom duration time, inflammatory parameters (ESR and CRP). The single parameter that predicted baseline ESSDAI was the presence of RF (P < 0.001). Only anti-SSB (p=0.004)) and antinuclear antibodies (p=0.003) emerged as predictors of positive SG ultrasound.

Conclusion: Our results imply that SG US does not predict baseline pSS disease activity, determined by ESSDAI.

References: 1. Milic V, et al. PLoS One 2019. doi: 10.1371/journal.pone.0226498. 2. Shiboski CH et al. Arthritis Rheumatol 2017. doi: 10.1136/annrheumdis-2016-210571.3. Hocevar A et al. Rheumatology (Oxford) 2005. doi: 10.1093/rheumatology/keh588.4. Seror R, et al. ARD 2010. doi: 10.1136/ard.2009.110619corr1.

Figure 1: ESSDAI by components in our pSS cohort.

Disclosures: K. Perdan Pirkmajer, None; M. TOMSIC, None; A. Hocevar, None.

To cite this abstract in AMA style:

Perdan Pirkmajer K, TOMSIC M, Hocevar A. Do Primary Sjögren’s Syndrome Patients with Normal Major Salivary Gland Ultrasound Have Less Active Disease? [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/do-primary-sjogrens-syndrome-patients-with-normal-major-salivary-gland-ultrasound-have-less-active-disease/. Accessed .

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