AB0560 EFFECT OF UPADACITINIB IN A PATIENT WITH PRIMARY SJOGREN SYNDROME: A CASE REPORT

Background Primary Sjogren syndrome (pSS) is a chronic autoimmune multisystem disease characterized by inflammation of exocrine glands, particularly the lacrimal and salivary as well multiple extraglandular involvements. Treatment often challenging, till now, no Disease-Modifying Antirheumatic Drugs (DMARD) have been approved for this condition. There lack data about efficacy Janus kinase inhibitors in pSS. Here we report patient with pSS successfully responding to upadacitinib. Objectives To see upadacitinib management primary syndrome. Methods A 68-year-old woman presented pain joints 16 years intermittent use NSAIDs. She had low back self or family history psoriasis red eye. denied dry mouth but required frequent water drinking during meals aid swallowing occasionally used artificial tears. MTX was started her two-month articular flare positive rheumatoid factor (RF). caused severe vomiting hyponatremia, she hospitalized. After correction put on tofacitinib. We reevaluated case when came us. grade 2-3 tenderness most peripheral bedridden. Immunological parameters revealed RF 127 IU/ml (reference value <14), anti-SSA antibody 147 U/ml (normal <3.2), anti-SSB 149 <8) anti-CCP antibody; ANA, anti-ds-DNA Ab were negative. erosion X-ray hands. Schirmer’s test (3 mm bilaterally). Unstimulated flow after five minutes 0.04 ml/min (≤0.1 indicates hypofunction). fulfilled 2016 ACR/EULAR classification criteria, diagnosed Considering age, switched upadacitinib, European Medicines Agency restricted tofacitinib beyond 65 years. Results Her EULAR Syndrome’s Disease Activity Index (ESSDAI) [1] six at baseline, indicating moderate activity. joint improved significantly within two months infrequent pilocarpine sixth month. Six treatment ESSDAI down 2; Patient’s Global Assessment score 02 achieved STAR (Sjogren’s Tool Assessing Response) response 7 (STAR responder if ≥5) [2]. Conclusion our knowledge, first Further high-quality clinical trials are confirm benefit References [1]. Ramos-Casals M, Brito-Zerón P, Bombardieri S, Bootsma H, De Vita Dörner T, Fisher BA, Gottenberg JE, Hernandez-Molina G, Kocher A, Kostov B. recommendations Sjögren’s topical systemic therapies. Annals rheumatic diseases. 2020 Jan 1;79(1):3-18. Seror R, Baron Camus Cornec D, Perrodeau E, Bowman SJ, B, Hueber W. Development preliminary validation Response (STAR): consensual composite assessing effect 2022 Jul 1;81(7):979-89. Acknowledgements: NIL. Disclosure Interests None Declared.