Ab0619 predictors for future development of systemic lupus erythematosus in korean sjögren’s syndrome patients

Background Sjögren’s syndrome (SS) can occur alone or in combination with other autoimmune diseases. Systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with SS. The prognosis of SS is generally better than that of SLE. However, the onset of SLE in these patients may be one of the factors that increase mortality. Objectives This study determined the impact of demographic factors, clinical manifestations, disease activity, and serological tests at baseline on future SLE development in Sjögren’s syndrome (SS) patients. Methods This retrospective study assessed 1,082 SS patients without other autoimmune diseases at baseline who visited our hospital between January 2012 and March 2021. We analyzed demographic features, extra-glandular manifestations (EGMs), clinical indices, and laboratory values at baseline between the two groups divided per future SLE development (SS/SLE group vs. SS group). The probability and predictors of SLE development in SS patients were estimated using the Kaplan–Meier method and Cox proportional hazards models. Results The median follow-up duration was 1083.5 days. Forty-nine patients (4.5%) developed SLE that met the 2012 Systemic Lupus International Collaborating Clinics or 2019 EULAR/ACR classification criteria. The baseline EULAR SS disease activity index (ESSDAI) score was significantly higher in the SS/SLE group ( p <0.001). The SS/SLE group had more lymphadenopathy and renal involvement ( p =0.015 and p =0.017, respectively). Shorter SS disease duration (<3 years) (hazard ratio [HR]=2.61, p =0.012), high ESSDAI (HR=3.04, p =0.024), leukopenia (HR=2.20, p =0.017), hypocomplementemia (HR=17.40, p <0.0001), and positive for anti-dsDNA (HR=19.93, p <0.0001), anti-ribonucleoprotein (RNP) (HR=2.96, p =0.025), and anti-ribosomal P (HR=2.74, p =0.048) at baseline were SLE development predictors in SS patients. Conclusion Shorter disease duration and higher disease activity of SS at baseline may be risk factors for future SLE development. Serologic predictors of SLE development are hypocomplementemia, leukopenia, and positivity for anti-dsDNA, anti-RNP, and anti-ribosomal P antibodies. If the above factors are observed, close monitoring will be necessary during the follow-up period, considering the possibility of future SLE development. References [1]Lazarus MN and Isenberg DA. Development of additional autoimmune diseases in a population of patients with primary Sjogren’s syndrome. Ann Rheum Dis . 2005; 64: 1062-4. [2]Pasoto SG, Adriano de Oliveira Martins V and Bonfa E. Sjogren’s syndrome and systemic lupus erythematosus: links and risks. Open Access Rheumatol . 2019; 11: 33-45 Figure 1. Comparison of disease activity (by ESSDAI score) and extraglandular manifestations (EGMs) at baseline between SS/SLE group and SS group. Acknowledgements No acknowledgements to declare. Disclosure of Interests None Declared.