AB0524 How do we treat dryness in patients with primary sjÖgren's syndrome? a nationwide study in spain from the sjogrenser registry. (12th June 2018) - Fernandez Castro, M.
Abstract : Background: Primary Sjögren syndrome (pSS) is a systemic autoimmune disease whose main characteristic is the involvement of the exocrine glandular system. Thus, its most common clinical manifestation is eye and mouth dryness. No therapy has been demonstrated to significantly modify disease course and, currently, evidence-based therapy for pSS is mainly limited to symptomatic drugs for drynes. Objectives: To describe the dryness treatment in a cohort of primary Sjögren Syndrome patients. Methods: SJOGRENSER registry is a multicentre descriptive cross-sectional study of pSS patients, fulfilling European/American criteria, from 33 Spanish rheumatology departments. Data were collected by reviewing clinical records and interviewing the patients. Informed consent was obtained and local ethics committees approved the study. Variables were analysed by descriptive statistics using means, medians and ranges. Chi square test was used to compare categorical variables. A p<0.05 was considered significant. Results: Four hundred and thirty seven patients were included (female 95%; median age 58 years). Ninety four per cent of the patients complained of daily, persistent, troublesome dry eyes for more than 3 months, 92% had sensation of sand in the eyes, 16% developed corneal ulcer. Ninety four per cent of the patients complained of dry mouth for more than 3 months and 27% had dental loss. The most frequent ocular dryness treatments were tear substitutes (96%), followed by lubricating ophthalmological ointments (46%), autologous sera solutions (14%), topical corticosteroids (13%), topical cyclosporine (6%). Comparing patients with and without ocular dryness, only pilocarpine and lubricating eye ointment were used significantly with more frequency in symptomatic patients (p<0.05); tear substitutes was used significantly with more frequency in symptomatic patients only in the subgroup of patients that used tear substitutes more than 3 times a day. The most frequent oral dryness treatments were chewing gums or candies without sugar (65%), followed by pilocarpine (56%), special toothpaste (22%), mucolytic agents (20%), saliva substitutes (19%), lubricating oral gel (13%) xylitol (11%) and fluoride (11%). Comparing patients with and without oral dryness, chewing gums or candies without sugar, xylitol and fluoride were not used significantly more frequently in symptomatic patients. In contrast, saliva substitutes, lubricating oral gel, pilocarpine, mucolytic agents and specific toothpaste were used significantly more frequently in symptomatic patients (p<0.05). The median in ESSPRI (Eular Sjögren's Syndrome Patient Reported Index) in SJOGRENSER cohort was 5.3 (p25-p75, 3.67–7). Only topical corticosteroids and pilocarpina were used significantly more frequently in patients with a dryness VAS≥5 in ESSPRI index. Conclusions: Despite the high number of symptomatic patients, the use of dryness treatments is limited in pSS patients. Chewing gums or candies without sugar, xylitol and fluoride remain underutilised in this cohort. Despite the dryness VAS score, patients do not seem to use all the symptomatic therapeutic options available. Disclosure of Interest: None declared