SAT0440 Phenotypic features and predictors of the clinical severity of keratoconjunctivitis sicca and salivary gland dysfunction in patients with sjÖgren’s syndrome: a longitudinal analysis of the kiss cohort

Background Hyposecretion of tears and saliva is the main phenotype of primary Sjogren’s syndrome (PSS). However, the prevalence and degree of ocular and oral involvement in PSS is highly variable. Objectives The aims of this study were 1) to investigate oral and ocular signs and changes in primary SS patients, and 2) to explore possible predisposing factors for moderate to severe oral or ocular signs in primary SS. Methods We analysed 140 participants from the Korean Initiative of PSS cohort who completed a two-year follow-up oral and ocular sign test. The severity of keratoconjunctivitis sicca (KCS) was determined by the Schirmer I test (Moderate-to-severe [MS],≤5 mm/5 min; mild [Mi],>5 mm/5 min). Salivary gland dysfunction (SGD) was determined by unstimulated whole salivary flow rate (UWS) (MS, UWS Results Among the 140 participants enrolled in this study, 108 (61%) were placed in the MS-KCS/MS-SGD group, 17 (24%) were in the MS-KCS/Mi-SGD, 15 (16%) were in the Mi-KCS/MS-SGD at the two-year follow-up. The MS-KCS/Mi-SGD group was younger than the other two groups, had a lower xerostomia inventory, and lower level of β2 microglobulin. Participants in the Mi-KCS/MS-SGD group had less hyperimmunoglobulinemia, rheumatoid factor (RF), antinuclear antibodies, anti-Ro, and anti-La antibodies. Older patients and those with positive RF, anti-Ro, or anti-La antibodies at baseline were more likely to have moderate to severe KCS at the two-year follow-up. Conclusions Patients with PSS and positive RF, anti-Ro, or anti-La antibodies at baseline may benefit from regular ophthalmology exams, even if they do not have KCS at baseline or dry eye symptoms. References [1] Le Gall M, Cornec D, Pers J-O, Saraux A, Jousse-Joulin S, Cochener B, et al. A prospective evaluation of dental and periodontal status in patients with suspected Sjogren’s syndrome. Joint Bone Spine. doi:http://dx.doi.org/10.1016/j.jbspin.2015.02.015. [2] Lim SA, Nam S, Kwok SK, Park SH, Chung SH. Serologic Markers Are Associated With Ocular Staining Score in Primary Sjogren Syndrome. Cornea2015;34:1466–70. [3] Shiboski CH, Baer AN, Shiboski SC, Lam M, Challacombe S, Lanfranchi HE, et al. Natural History and Predictors of Progression to Sjogren’s Syndrome Among Participants of the Sjogren’s International Collaborative Clinical Alliance Registry. Arthritis Care Res (Hoboken)2017. doi:10.1002/acr.23264. Acknowledgements We wish to thank So Young Kim, the research nurse for the KISS cohort, for her excellent support. Disclosure of Interest None declared