THU0110 DISEASE ACTIVITY AND PATIENT-REPORTED OUTCOMES IN PATIENTS WITH RA WITH SJÖGREN’S SYNDROME ENROLLED IN A LARGE OBSERVATIONAL US REGISTRY

Background:Dryness, fatigue, and pain are common clinical manifestations assessed by EULAR Sjogren’s Syndrome Patient Reported Index (ESSPRI)-Dryness, -Fatigue, -Pain scores in patients with primary Sjögren’s syndrome (pSS). In addition, depression is also seen in these patients owing to the pattern of the chronic disease.Objectives:The aim of the study was to assess the complex interactions among Depression status, Illness Perception, and prominent clinical manifestations evaluated by the ESSPRI (Dryness, Fatigue, and Pain) in patients with pSS.Methods:In this cross-sectional study, 111 patients with pSS (M/F: 5/106; mean age: 52.9 ± 12.01 years) were included. The data were collected by clinical examination and a questionnaire regarding patient reported outcome measures (PROMs). Unstimulated (U-WSFR) and stimulated (S-WSFR) whole saliva flow rates of patients were calculated as ml/min. Hospital Anxiety and Depression Scale (HADS), Illness Perception Questionnaire-R (IPQ-R) and EULAR Sjogren’s Syndrome Patient Reported Index were filled by patients. Increases in HADS score and subgroup scores of ESSPRI (Dryness, Fatigue and Pain) and IPQ-R dimensions regarding Identity, Consequences, and Emotional reflected poor conditions for patients. In addition, patients scored their disease activity (0: inactive-100: the worst activity) by using 100-mm visual analogue scale (VAS). After preliminary analysis, a mediation analysis was used to evaluate the relations among these variables.Results:In the study, ESSPRI-Dryness score (6,27±2,79) was associated with U-WSFR (0,40±0,57) and S-WSFR (1,04±0,86),(r:-0,4 p=0.000; r:-0,3 p=0.004). Moreover, patients reported disease activity score (48,78±26,67) was related to U-WSFR (r: -0,3 p=0.026) as well as Consequence (19,12±5,47) and Emotional (19,54±7,02) scores of IPQ-R questionnaire (r: 0,3 p=0.035; r: 0,3 p=0.014).In IPQ-R questionnaire, Identity score (8,04±3,1) reflecting number of symptoms that patients experienced due to their illness was correlated with scores of ESSPRI-Fatigue (5,29±2,97), ESSPRI-Pain (5,18±3,01), HADS-Anxiety (11,67±5,55), HADS-Depression (9,2±4,98) in the study (p<0.05).In the mediation analysis, Identity score was directly mediated by ESSPRI-Fatigue score (p=0.0093) and indirectly mediated by HADS-Depression score (p=0.0011).A bootstrap analysis with 5000 replications was applied to estimate mediation effect to generate 95% CI. Percentile bootstrap of HADS-Depression was found to be an effective mediator for Identity score based on 5000 bootstrap sample.Conclusion:Both depression status and fatigue affected Identity score reflecting the number of symptoms poorly. Considering this complex relationship in disease activity assessment may positively affect disease outcomes.Disclosure of Interests:None declared

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THU0266 RESILIENCE IN WOMEN WITH PRIMARY SJÖGREN’S SYNDROME

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4757 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 360.2-360

Author(s):

F. Giardina ◽

G. Curcio ◽

R. Izzo ◽

S. Colafrancesco ◽

A. Gattamelata ◽

...

Keyword(s):

Disease Activity ◽

Sjögren’S Syndrome ◽

Sjögren's Syndrome ◽

Sjogren’S Syndrome ◽

Sjogren's Syndrome ◽

Resilience Scale ◽

Patient Reported ◽

Sjögren‘S Syndrome

Background:Resilience is the ability to react positively to stressful life events, a multidimensional feature that varies in relation to context, time, age, sex, culture and personal experience, appearing among the most important traits in patients suffering from rheumatic diseases1. Several studies focus on patients with RA and SLE and the role of resilience in the respective clinical manifestations, as well as in the development of anxiety and depression2,3. Conversely, the data available regarding patients with primary Sjögren’s Syndrome (pSS) are limited.Objectives:To assess, in women with pSS (classified according to the criteria of Vitali et al.4), the relationship between resilience and anxiety, depression, health, fatigue, physical activity and quality of life in relation to disease activity and duration and in consideration of demographic, job and cultural characteristics.Methods:74 female patients with pSS afferent to the dedicated clinic of the University Hospital Policlinico Umberto I of Rome were recruited. Resilience was assessed by administering the Italian validated version of the Resilience Scale (RS-14)5consisting of 14 items, each of which is assigned a score from 1 to 7, with a range from 14 to 98. Higher scores relate to greater resilience. ESSDAI (EULAR Sjögren’s syndrome disease activity index), ESSPRI (EULAR Sjogren’s Syndrome Patient Reported Index), SSDDI (Sjogren’s Syndrome Disease Damage Index) were assessed and EuroQol / GH EQ VAS (visual analogue scale), HADS (Hospital Anxiety and Depression Scale), SF-12 (Short-form 12 health survey), FAS (Fatigue Assesment Scale), IPAQ (International Physical Activity Questionnaire), FACIT-F (Functional Assessment of Chronic Illness Therapy – Fatigue) questionnaires were submitted. Educational qualifications and job were also considered. The statistical analysis was carried out by means of Spearman’s correlation.Results:No relationship was found between resilience, systemic disease activity, disease duration, patient-reported symptoms and damage. Furthermore, no apparent link was found between socio-demographic characteristics, employment and resilience. Conversely, an inverse relationship was found between resilience and mood disorders (p=0.0379), with greater resilience associated with a better perception of quality of life (p=0.0232) and general health (p=0.0002), mainly mental (p=0.0001) than physical (p=0.0035), as well as less fatigue (p=0.0079) and more phyisically active lifestyle (p=0.0012)Conclusion:For the first time, the role of resilience in women with pSS in relation to their disease and other individual parameters was assessed. The most resilient patients are less depressed and show better perception of their health. Greater resilience tends to correlate with less anxiety, physical and mental fatigue and a more active lyfestile, while there was no relation between resilience value, active disease and socio-demographic features.References:[1]Rojas M. et al., Resilience in women with autoimmune rheumatic diseases, Joint Bone Spine (2017).[2]Sílvia Fernanda Cal et al., Resilience in systemic lupus erythematosus, Psychology, Health & Medicine (2013), 18:5, 558-563.[3]NeiLi Xu et al., Associations of perceived social support and positive psychological resources with fatigue symptom in patients with rheumatoid arthritis.PLoS One. 2017; 12(3).[4]Vitali C, et al. Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002; 61:554-558.[5]Camilla Callegari et al., Reliability and validity of the Italian version of the 14-item Resilience Scale, Psychology Research and Behavior Management 2016:9 277–284.Disclosure of Interests:None declared

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Defining disease activity states and clinically meaningful improvement in primary Sjögren's syndrome with EULAR primary Sjögren's syndrome disease activity (ESSDAI) and patient-reported indexes (ESSPRI)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2014-206008 ◽

2014 ◽

Vol 75 (2) ◽

pp. 382-389 ◽

Cited By ~ 94

Author(s):

Raphaèle Seror ◽

Hendrika Bootsma ◽

Alain Saraux ◽

Simon J Bowman ◽

Elke Theander ◽

...

Keyword(s):

Disease Activity ◽

Sjögren’S Syndrome ◽

Sjögren's Syndrome ◽

Sjogren’S Syndrome ◽

Sjogren's Syndrome ◽

Primary Sjögren’S Syndrome ◽

Primary Sjogren’S Syndrome ◽

Primary Sjögren's Syndrome ◽

Patient Reported ◽

Sjögren‘S Syndrome

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FRI0182 RISK FACTORS ASSOCIATED WITH RENAL INVOLVEMENT IN PRIMARY SJÖGREN’S SYNDROME: DATA FROM THE SPANISH SJÖGRENSER COHORT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5149 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 674.3-675

Author(s):

J. Narváez ◽

C. Sánchez-Piedra ◽

M. Fernandez Castro ◽

V. Martinez Taboada ◽

A. Olive ◽

...

Keyword(s):

Risk Factors ◽

Renal Disease ◽

Disease Activity ◽

Sjögren’S Syndrome ◽

Sjögren's Syndrome ◽

Renal Involvement ◽

Sjogren’S Syndrome ◽

Sjogren's Syndrome ◽

Primary Sjögren’S Syndrome ◽

Sjögren‘S Syndrome

Objectives:To investigate the prevalence, risk factors, and effects of primary renal disease on morbidity and mortality in patients with primary Sjögren’s syndrome (pSS).Methods:All patients in the SJÖGRENSER (registry of adult SSp patients of the Spanish Society of Rheumatology, cross-sectional phase) cohort were retrospectively investigated for the presence of clinically significant renal involvement directly related to pSS activity.Results:Of the 437 patients investigated, 39 (9%) presented overt renal involvement during follow-up. Severe renal disease necessitating kidney biopsy was relatively rare (23%).Renal involvement may complicate pSS at any time during the disease course and is associated with severe disease (indicated by higher scores of involvement, activity, and damage), systemic multiorgan involvement, and a higher frequency of lymphoma. Multivariate analysis showed that older age (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.00–1.07), higher European League Against Rheumatism Sjogren’s Syndrome Disease Activity Index scores (OR 1.1, CI 1.03–1.18), serum anti-La/SSB positivity (OR 6.44, CI 1.36–30.37), and non-vasculitic cutaneous involvement (OR 8.64, 1.33–55.90) were independently associated with this complication.Chronic renal failure developed in 23 of 39 patients (59%); only 1 of them progressed to end-stage renal disease necessitating renal replacement therapy. Patients with renal disease showed higher Sjögren’s syndrome disease damage index scores (SSDDI), higher rates of hospitalization due to disease activity and higher rates of clinically relevant comorbidities.Conclusion:Renal involvement is an uncommon complication in pSS that was observed in 9% of patients. Although categorized as a non-negligible comorbidity, this condition shows a favorable prognosis.Disclosure of Interests:None declared

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