ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 623

Seronegative Sjögren’s Syndrome Is Characterized By a Lower Prevalence of B-Cell Related Clinical Manifestations and a Lower Biologic Systemic Activity

Luca Quartuccio1, Chiara Baldini2,3,4, Elena Bartoloni Bocci5, Roberta Priori6, Francesco Carubbi7, Laura Corazza1, Alessia Alunno8, Serena Colafrancesco6, Nicoletta Luciano2, Roberto Gerli9, Roberto Giacomelli10, Guido Valesini11, Stefano Bombardieri12 and Salvatore De Vita13,14, 1S. Maria della Misericordia, University of Udine, Italy, Udine, Italy, 2Internal Medicine, University of Pisa, Pisa, Italy, 3University of Pisa, Rheumatology Unit, Pisa, Italy, 4Department of Internal Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy, 5Rheumatology Unit, Department of Medicine, University of Perugia, Pila, Italy, 6Rheumatology Unit, Sapienza University of Rome, Rome, Italy, 7Rheumatology Clinic, University of L'Aquila, L'Aquila, Italy, 8Clinical and Experimental Medicine, Rheumatology Unit, University of Perugia, Perugia, Italy, 9Rheumatology Clinic, University of Perugia, Perugia, Italy, 10University of L'Aquila, L'Aquila, Italy, 11Internal Medicine and Medical Specialties Department, Policlinico Umberto I, La Sapienza University of Rome, Roma, Italy, 12Rheumatology Unit, University of Pisa, Italy, Pisa, Italy, 13Santa Maria della Misericordia Hospital, University of Udine, Udine, Italy, 14Rheumatology, DSMB, University Hospital Santa Maria della Misericordia, Udine, Italy

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: , , ,

Session Information

Date: Sunday, November 8, 2015

Title: Sjögren's Syndrome Poster I: Clinical Insights into Sjögren's Syndrome

Session Type: ACR Poster Session A

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

Background/Purpose: The American-European Consensus Group (AECG) Criteria (1) for Sjögren’s syndrome (SS) require the presence of at least one of the following two conditions: the histopathology (focus score > / = 1) or the presence of anti- SSA and / or SSB antibodies. The study aims to compare patients who, while satisfying the AECG criteria, do not present the positivity for anti-SSA/SSB antibodies, with patients that meet the AECG criteria and are positive for anti-SSA/SSB antibodies.

Methods: 598 patients were selected from the database of the Italian study group on SS (2) based on the following criteria: 1. Fulfillment of the AECG criteria for SS, 2. Execution of the biopsy of the minor salivary glands, 3. Search for anti-SSA/SSB antibodies, 4. Absence of hepatitis C virus infection. Univariate and multivariate analyses were performed. Differences were considered significant for P value <0.05. Variables with P <0.1, were then selected for the multivariate analysis.

Results: 206 patients were positive for histopathology, but negative for autoantibodies (group 1), 342 were positive for both the histopathology and for anti-SSA/SSB antibodies (group 2), and finally 50 patients were negative for the histopathology and positive for anti-SSA/SSB antibodies (group 3). This group has been excluded from the comparisons for the small size.

We found the following statistically significant differences between the two groups of patients (group 1 vs. group 2): age at diagnosis [mean ± standard error (SE)] (55 ± 0.8 vs. 48 ± 0.8, p <0.0001), glandular swelling (52/206 vs. 121/342, p = 0.013), skin involvement (14/206 vs. 47/342, p = 0.01), hematologic involvement (47/206 vs. 124/342, p = 0.001), leukopenia (36/170 vs. 110/230, p = 0.0001), lymphoma (22/342 vs. 2/206, p = 0.002), low C3 (24/187 vs. 63/316, p = 0.04), low C4 (12/187 vs. 43/316, p = 0.013), hypergammaglobulinemia (37/200 vs. 214/336, p <0.0001), ANA (323 vs. 133/202 / 337, p <0.0001), rheumatoid factor (59/198 vs. 224/331, p <0.0001), serum cryoglobulins (24/278 vs. 5/149, p = 0.039). The duration of follow-up (mean ± SE) was higher in the group 2 (4.0 ± 0.4 vs. 5.6 ± 0.3, p = 0.001).

By contrast, there were no statistically significant differences for the following variables: sex, dry eye, dry mouth, joint involvement, Raynaud’s phenomenon, purpura, kidney, lung, central and peripheral nervous system involvements, stomach, heart or muscle involvements, fibromyalgia, and the presence of serum monoclonal component, or prevalence of thyroiditis.

By multivariate analysis the following variables were selected as associated with the group 2: antinuclear antibodies (OR 6.9 95% CI 3.2 to 15.1), hypergammaglobulinemia (OR 5.1 95% CI 2.9 to 9.0 ), rheumatoid factor (OR 2.3 95% CI 1.4 to 3.9), age at diagnosis (OR 0.9 95% CI from 0.96 to 0.99).

Conclusion: B-cell related clinical manifestations and biologic activity appears less relevant in seronegative SS. Personalized treatment in SS as well as trial design of new therapies for SS should take into account these differences for patients’ recruitment beyond the fulfillment of the classification criteria.

Disclosure: L. Quartuccio, None; C. Baldini, None; E. Bartoloni Bocci, None; R. Priori, None; F. Carubbi, None; L. Corazza, None; A. Alunno, None; S. Colafrancesco, None; N. Luciano, None; R. Gerli, None; R. Giacomelli, None; G. Valesini, None; S. Bombardieri, None; S. De Vita, None.

To cite this abstract in AMA style:

Quartuccio L, Baldini C, Bartoloni Bocci E, Priori R, Carubbi F, Corazza L, Alunno A, Colafrancesco S, Luciano N, Gerli R, Giacomelli R, Valesini G, Bombardieri S, De Vita S. Seronegative Sjögren’s Syndrome Is Characterized By a Lower Prevalence of B-Cell Related Clinical Manifestations and a Lower Biologic Systemic Activity [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/seronegative-sjogrens-syndrome-is-characterized-by-a-lower-prevalence-of-b-cell-related-clinical-manifestations-and-a-lower-biologic-systemic-activity/. Accessed .

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