TY - JOUR
T1 - Clinical Phenotyping of Primary Sjogren Syndrome Patients Using Salivary Gland Ultrasonography
T2 - Data From the RESULT Cohort
AU - Mossel, Esther
AU - van Nimwegen, Jolien F.
AU - Stel, Alja J.
AU - Wijnsma, Robin F.
AU - Delli, Konstantina
AU - van Zuiden, Greetje S.
AU - Olie, Lisette
AU - Vehof, Jelle
AU - Los, Leonoor
AU - Vissink, Arjan
AU - Kroese, Frans G. M.
AU - Arends, Suzanne
AU - Bootsma, Hendrika
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Objective. To investigate salivary gland ultrasound (SGUS) abnormalities in relation to clinical phenotype and patient characteristics, disease activity, and disease damage in patients with primary Sjogren syndrome (pSS).Methods. Consecutive outpatients included in our REgistry of Sjogren Syndrome LongiTudinal (RESULT) cohort were selected. Patients with pSS who were included were classified according to the American College of Rheumatology/European League Against Rheumatism (EULAR) criteria and underwent full ultrasonographic examination (However score 0-48) at baseline. Total SGUS scores of >= 15 were considered positive. Patient characteristics, disease activity, and disease damage were compared between the different SGUS groups.Results. In total, 172 of 186 patients with pSS were eligible, of whom 136 (79%) were SGUS positive. Compared with patients who were SGUS negative, SGUS-positive patients had significantly longer disease duration, higher EULAR Sjogren Syndrome Disease Activity Index, higher Sjogren Syndrome Disease Damage Index, and were more likely to have a positive parotid gland biopsy, anti-SSA/SSB antibodies, and abnormal unstimulated whole saliva (UWS) and ocular staining score (OSS), and higher levels of IgG and rheumatoid factor. Regarding patient-reported outcome measurements (PROM), patients who were SGUS positive scored significantly lower on the EULAR Sjogren Syndrome Patient-Reported Index for fatigue and pain, and more often found their disease state acceptable compared with patients who were SGUS negative. SGUS total score showed significant associations with various clinical and serological variables, and with PROM. Highest associations were found for UWS (p = -0.551) and OSS (p = 0.532).Conclusion. Patients who were SGUS positive show a distinct clinical phenotype in all aspects of the disease compared with patients who were SGUS negative: clinical, functional, serological, and PROM. SGUS could be a helpful tool in selecting patients for clinical trials and estimating treatment need.
AB - Objective. To investigate salivary gland ultrasound (SGUS) abnormalities in relation to clinical phenotype and patient characteristics, disease activity, and disease damage in patients with primary Sjogren syndrome (pSS).Methods. Consecutive outpatients included in our REgistry of Sjogren Syndrome LongiTudinal (RESULT) cohort were selected. Patients with pSS who were included were classified according to the American College of Rheumatology/European League Against Rheumatism (EULAR) criteria and underwent full ultrasonographic examination (However score 0-48) at baseline. Total SGUS scores of >= 15 were considered positive. Patient characteristics, disease activity, and disease damage were compared between the different SGUS groups.Results. In total, 172 of 186 patients with pSS were eligible, of whom 136 (79%) were SGUS positive. Compared with patients who were SGUS negative, SGUS-positive patients had significantly longer disease duration, higher EULAR Sjogren Syndrome Disease Activity Index, higher Sjogren Syndrome Disease Damage Index, and were more likely to have a positive parotid gland biopsy, anti-SSA/SSB antibodies, and abnormal unstimulated whole saliva (UWS) and ocular staining score (OSS), and higher levels of IgG and rheumatoid factor. Regarding patient-reported outcome measurements (PROM), patients who were SGUS positive scored significantly lower on the EULAR Sjogren Syndrome Patient-Reported Index for fatigue and pain, and more often found their disease state acceptable compared with patients who were SGUS negative. SGUS total score showed significant associations with various clinical and serological variables, and with PROM. Highest associations were found for UWS (p = -0.551) and OSS (p = 0.532).Conclusion. Patients who were SGUS positive show a distinct clinical phenotype in all aspects of the disease compared with patients who were SGUS negative: clinical, functional, serological, and PROM. SGUS could be a helpful tool in selecting patients for clinical trials and estimating treatment need.
KW - cohort studies
KW - salivary glands
KW - Sjogren syndrome
KW - ultrasound
KW - RHEUMATISM CLASSIFICATION CRITERIA
KW - 2016 AMERICAN-COLLEGE
KW - RHEUMATOLOGY/EUROPEAN LEAGUE
KW - DISEASE-ACTIVITY
KW - ULTRASOUND
KW - CONSENSUS
KW - BIOPSY
KW - DYSFUNCTION
KW - DIAGNOSIS
KW - INDEX
U2 - 10.3899/jrheum.200482
DO - 10.3899/jrheum.200482
M3 - Article
C2 - 33004530
SN - 0315-162X
VL - 48
SP - 717
EP - 727
JO - The Journal of Rheumatology
JF - The Journal of Rheumatology
IS - 5
ER -