POS0737 SICCA SYNDROME: A MULTIMODAL ASSESSEMENT TO CHARACTERIZE PATIENT COHORTS BEYOND SJÖGREN’S SYNDROME CLASSIFICATION CRITERIA

Background Sicca syndrome represents a heterogeneous group of conditions, including Sjögren syndrome, causing xerophthalmia and xerostomia. Objectives This study characterizes in depth patients with evaluates salivary gland ultrasound (SGUS) this cohort. Methods Principal component analysis hierarchical clustering clinical parameters, ESSPRI, ESSDAI laboratory data were performed on all referrals for assessment symptoms between October 2018 March 2021. SGUS labial biopsies compared across groups. Results 583 assessed. Objective dryness was confirmed 73% patients. Cluster identified 3 groups post-hoc confirming distinct phenotypes: Somatic Group (283/583; 49%) higher reported but limited objective dryness; Dry Without Autoimmune Features (DAF neg , 206/532; 35%) With pos 94/532; 16%). DAF had highest autoantibody titres (SSA 240 vs 3.6 3.8; p<0.001), most extra-glandular manifestations (p<0.001) median Score : 8 [IQR 4-10] SG: 2 [1-4] 4 [2-5]; p< 0.001). No tangible correlation primary criteria observed. Conclusion score correlated subset patients, the cluster. highlights heterogeneity within indeed highlighting need further studies. References [1]Chisholm DM, Mason DK. Labial biopsy Sjogren’s disease. J Clin Pathol. 1968;21(5):656-60 [2]De Vita S, Lorenzon G, Rossi Sabella M, Fossaluzza V. Salivary echography secondary syndrome. Exp Rheumatol. 1992;10(4):351-6 Table 1. Comparing contrasting demographics attributes entire cohort subdivided into three through principal subsequent clustering. are shown as mean interquartile range unless otherwise stated. p N (%) 283 (49) 206 (35) 94 (16) Female, n 239 (84) 142 (69) 81 (86%) <0.001 Age at Onset, yrs 47.3 [36.6-55.9] 60.2 [51.1-67.3] 50.1 [35.5-59.4] BMI, kgm -2 26.1 [23.0-31.0] 24.7 [21.7-27.7] 24.6 [22.4-28.0] 0.003 Smoker, 50 (18) 15 (7) (4) 0.06 ESSPRI Scores - Dryness 6 [3-7] [1-3] [2-7] Limb Pain 7 [5-8] 5 [2-6] [4-8] Fatigue [6-9] [2-5] [3-8] Reported Symptoms Raynaud, 86 (30) 51 (25) 44 (47) 0.006 Arthralgia, 222 (78) 118 (57) 61 (65) 0.002 Myalgia, 197 (70) 87 (42) 40 (43) Stiffness, 98 37 23 0.001 Parotitis, 62 (22) 24 (12) 33 Sand corn, 168 (59) Ocular Inf, 120 45 26 (27) 0.005 [2-12] [0-11] 11 [4-17] Antibody Titres ANA ≥ 1:160 178 (63) 152 (74) RhF U/ml 10.0 [10.0-10.9] [10.0-11.3] 23.3 [11.7-71.0] Alpha-Fodrin 9 [5-22] [6-19] 12 [6-25] 0.05 anti-SSA(Ro) [0.3-101.3] 3.8 [0.3-102.3] 240.0 [192.8-240.0] anti-SSB(La) 0.4 [0.3-3.4] 0.3 [0.3-1.9] 73.1 [3.8-312.5] Measurable Saxon, g 3.5 [2.4-4.9] 4.2 [3.3-5.3] 2.3 [0.6-3.7] Schirmer, mm 7.0 [2.0-17.9] 3.0 [0.5-12.0] 2.5 [0.0-7.1] Gland Biopsy, Biopsy 150 (53) (58) 18 (19) Chisholm ≥3 66 (44) 64 (50) Median [2-3] [3-4] Ultrasound, = 0 39 (14) 1 (1) ≥6 73 (26) 55 38 (41) [4-10] Figure A 3D scatterplot composed first dimensions analysis, providing greatest inertia gain The (SG) represented by black points. Patients without autoimmune features ) pink points green dots. Acknowledgements We would like to express our gratitude staff Rheumatology Outpatients Department Hannover Medical School their continual help organization patients: G Mielke, Lahn, Dr. S Hirsch. Disclosure Interests Emelie Kramer: None declared, Tabea Seeliger: Thomas Skripuletz: Vega Gödecke: Sonja Beider: Alexandra Jablonka: Torsten Witte: Diana Ernst Grant/research support from: financially supported Novartis. funder not involved design, collection, interpretation data, writing article or decision submit it publication.