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Abstract Number: 2693

Evolution of Disease Activity over a 5-Year Period in the  395 Patients with Primary SjöGren’s Syndrome of the Assess Prospective Cohort

Jacques-Eric Gottenberg1, Raphaele Seror2, Alain Saraux3, Valerie Devauchelle4, Emmanuelle Dernis Labous5, Philippe Dieudé6, Jean-Jacques Dubost7, Anne Laure Fauchais8, Vincent Goeb9, Claire Larroche10, Véronique Le-Guern11, Eric Hachulla12, Pierre Yves Hatron13, Jacques Morel14, Aleth Perdriger15, Stephanie Rist Bouillon16, Damien Sène17, Olivier Vittecoq18, Jean Sibilia19, Philippe Ravaud20 and Xavier Mariette21, 1Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France, 2Department of Rheumatology, Assistance Publique–Hopitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bicêtre, France, 3Rheumatology, Brest University Hospital, Brest, France, 4Service de Rhumatologie, Department of Rheumatology, Brest University Hospital, Brest, France, Brest, France, 5Le Mans Hospital, Le Mans, France, 6Rheumatology, Hôpital Bichat, Paris, France, 7Rheumatology department CHU Clermont-Ferrand, Clermont-Ferrand, France, 8Rheumatology, Limoges, France, 9Rhumatologie, CHU Amiens, Amiens, France, 10Internal Medicine, Paris, France, 11service de médecine interne, Department of Internal Medicine, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, AP–HP, Université Paris Descartes, Paris, France, 12Internal Medicine, Lille University Hospital, Lille, France, 13Internal Medicine, Lille, France, 14Rheumatology, Department of Rheumatology, Montpellier University Hospital, Montpellier, France, 15C.H.R. Hôpital Sud, Rennes, France, 16Rhumatologie, Hopital La Source, La Source, France, 17Department of Internal Medicine, Pitié-Salpêtrière Hospital, Paris, France, 18Rheumatology, Rouen University Hospital &INSERM U905, Rouen, France, 19Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France, 20Epidemiologist, PARIS, France, 21Rheumatology, Rheumatology department, Bicetre Hospital, Paris-Sud University, Le Kremlin Bicetre, France

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: biomarkers and registry, Sjogren's syndrome

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Session Information

Date: Tuesday, November 15, 2016

Session Title: Sjögren's Syndrome - Poster II: Clinical Science

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Little is known about the natural history of primary Sjögren’s syndrome due to the limited number of prospective cohorts followed up in a yearly manner. International validated disease activity scores were recently established and are now used as inclusion criteria and as primary outcome measures in many randomized controlled trials. This is therefore of critical importance to know the evolution of these scores and the proportion of patients experiencing a change in these scores.

Methods: The ASsessment of Systemic complications and Evolution in primary Sjögren’s Syndrome (ASSESS) cohort is a prospective ongoing cohort of 395 patients. All patients have a medical examination every year by a trained physician, who collects the ESSDAI (Eular Sjögren’s Syndrome Disease Activity Index), which scores systemic disease activity, clinical ESSDAI (clin ESSDAI, which scores systemic disease activity without the biological domain of the ESSDAI)and the ESSPRI (Eular Sjögren’s Syndrome Patient Index), a patient-related outcome which scores dryness, pain and fatigue.

Results: Baseline data At enrollment in the 395 patients of the cohort, median ESSDAI, clin ESSDAI and ESSPRI were 3 [2-8], 3 [0-8] and 5.7 [4-7], respectively. 28.2% and 10.6% of patients had moderate systemic disease activity (5≤ ESSDAI < 13) or high systemic disease activity (ESSDAI ≥ 14), respectively. 62.2% of patients had an ESSPRI≥ 5. Follow-up data During the 5 years of annual follow up, 23.3 and 23.4% of patients with a baseline ESSDAI or a clinESSDAI < 5, respectively, had at least at one follow up visit, an ESSDAI or clinESSDAI ≥ 5. 10.5% and 12.9% of patients with a baseline ESSDAI<14 or clinESSDAI<14, respectively, had at least at one follow up visit an ESSDAI or clin ESSDAI≥14. Regarding changes in domains of the ESSDAI over the 5 years of follow up, the most frequent changes were observed in the biological (46.2% of patients), articular (34.9%), hematological (28.9%), pulmonary (25.1%), and glandular domain (20.5%). 25% of patients with a baseline ESSPRI<5 had at least at follow up one visit an ESSPRI ≥5. 39.8% of patients with baseline ESSDAI and ESSPRI<5 had at least at one follow up visit an ESSDAI or an ESSPRI ≥5.

Conclusion: Systemic manifestations and symptoms evolve over time during the 5-year follow-up in patients with primary Sjögren’s Syndrome. Approximately one fourth of the patients with no systemic activity or an acceptable symptoms status at baseline evolved to a status of moderate disease activity or to disabling symptoms, respectively. 40% of patients without any active disease or disabling symptoms at baseline developed systemic complications or disabling symptoms within 5 years.


Disclosure: J. E. Gottenberg, Abbvie, BMS, Gsk, Jannssen, Lilly, MSD, Pfizer, Roche, UCB, 5; R. Seror, None; A. Saraux, None; V. Devauchelle, None; E. Dernis Labous, None; P. Dieudé, None; J. J. Dubost, None; A. L. Fauchais, None; V. Goeb, None; C. Larroche, None; V. Le-Guern, None; E. Hachulla, None; P. Y. Hatron, None; J. Morel, None; A. Perdriger, None; S. Rist Bouillon, None; D. Sène, None; O. Vittecoq, None; J. Sibilia, None; P. Ravaud, None; X. Mariette, None.

To cite this abstract in AMA style:

Gottenberg JE, Seror R, Saraux A, Devauchelle V, Dernis Labous E, Dieudé P, Dubost JJ, Fauchais AL, Goeb V, Larroche C, Le-Guern V, Hachulla E, Hatron PY, Morel J, Perdriger A, Rist Bouillon S, Sène D, Vittecoq O, Sibilia J, Ravaud P, Mariette X. Evolution of Disease Activity over a 5-Year Period in the  395 Patients with Primary SjöGren’s Syndrome of the Assess Prospective Cohort [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/evolution-of-disease-activity-over-a-5-year-period-in-the-395-patients-with-primary-sjogrens-syndrome-of-the-assess-prospective-cohort/. Accessed January 20, 2021.
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