Clinical Phenotyping of Primary Sjogren Syndrome Patients Using Salivary Gland Ultrasonography: Data From the RESULT Cohort

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Abstract

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.

Original languageEnglish
Pages (from-to)717-727
Number of pages11
JournalThe Journal of Rheumatology
Volume48
Issue number5
Early online date1-Oct-2020
DOIs
Publication statusPublished - 1-May-2021

Keywords

  • cohort studies
  • salivary glands
  • Sjogren syndrome
  • ultrasound
  • RHEUMATISM CLASSIFICATION CRITERIA
  • 2016 AMERICAN-COLLEGE
  • RHEUMATOLOGY/EUROPEAN LEAGUE
  • DISEASE-ACTIVITY
  • ULTRASOUND
  • CONSENSUS
  • BIOPSY
  • DYSFUNCTION
  • DIAGNOSIS
  • INDEX

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