Background Sjögren's syndrome (SS) is a chronic autoimmune disease that causes salivary and lacrimal gland dysfunction, resulting in oral and ocular dryness. The European League Against Rheumatism (EULAR) SS disease activity index (ESSDAI) is a systemic disease activity index measuring disease activity in patients with SS. The ESSDAI includes 12 domains. EULAR SS patient-reported index (ESSPRI) is used to evaluate dryness, fatigue, and pain symptoms, and their impact on the disease. Routine Assessment of Patient Index Data 3 (RAPID3) is used to evaluate disease activity in patients with rheumatoid arthritis which is another inflammatory disorder.
Objectives This study aims to evaluate whether RAPID3 is useful in primary SS.
Methods 30 patients with primary SS were enrolled in the study. ESSDAI, ESSPRI and RAPID3 scores were recorded. Chi-square, Mann Whitney U test and Pearson correlation analysis were performed for the statistical analysis.
Results Demographically and clinical data were shown in the Table-1. Mean ESSDAI, ESSPRI and RAPID3 scores were 3.8±3.6, 5.8±1.7, and 14.8±5.2, respectively. RAPID3 scores were positively correlated ESSPRI (r=0.669, p<0.001). In addition, when we set the cut-off value to 12 on the RAPID3 score (>12 accepted as active, and ≤12 accepted as inactive), ESSPRI score was significantly higher in active patients (6.4±1.4 vs. 4.1±1.4, p=0.002). However, there was no relationship between RAPID3 and ESSDAI scores.
Schirmer test was positively correlated with tear break up time (BUT) (r=0.573, p=0.007). Lissamine green score was negatively correlated with Schirmer test and BUT (r=-0.484, p=0.007, and r=-0.507, p=0.004, respectively). Despite there was high compliance among these three scales evaluating eye involvement, these scales did not appear to correlate with the ESSDAI, ESSPRI, and RAPID3 scores that assess global disease activity. The mean age was significantly higher in patients with Schirmer test ≤5 mm compared to the patients with >5 mm (55.6±6.9 vs. 47.6±8.5 years, p=0.044).
Conclusions In SS, it is not simple to detect disease activity. Comorbid psychosomatic diseases affect the set detecting global disease activity. On the other hand, the activity of glandular involvement and global disease activity are not with compliance. Therefore, new and easy tools are necessary in primary SS. In our study, RAPID3 score is corelated with ESSPRI. This result suggests that RAPID3 is useful to detect disease activity in primary SS.
Disclosure of Interest None declared