INTEGRATION OF SALIVARY-GLAND ULTRASONOGRAPHY IN CLASSIFICATION CRITERIA FOR PRIMARY SJOGREN'S SYNDROME: AN INTERNATIONAL VIGNETTE-BASED STUDY

Background The recent classification criteria sets for primary Sjogren9s syndrome (AECG 2002 and ACR/EULAR 2017) did not include major salivary glands ultrasononography (SGUS). Objectives The UTOPIA study was undertaken to determine if and how SGUS may improve the ACR/EULAR criteria. Methods Twenty four international experts in pSS evaluated on an internet-secure relational database 512 randomly realistic vignettes derived from 150 patients with suspected pSS included in the french DiapSS cohort. Each vignette contained sections on “history” (duration of the symptoms, gender, age), clinical symptoms (dry mouth, dry eyes and systemic manifestations), results of the SGUS evaluation (score > ou Results Univariate and multivariate analyses confirmed that ACR/EULAR criteria and SGUS were independently associated with the diagnosis of pSS. Disease duration, OSS and ocular dryness were not associated with the diagnosis of pSS. Only 6 variables were selected by logistic regression analysis: presence of anti-SSA (weight:4), focus score (weight:3), SGUS (weight:2), Schirmer9s test (weight:1), dry mouth (weight:1) and salivary flow rate (weight:1). According to ROC curve analysis, a score of ≥5 had 96% Se and 84% Sp, compared with 90% Se and 84% Sp for the ACR/EULAR criteria. The corrected C statistic (AUC) for the new weighted score was 0.98. Conclusions Inclusion of the SGUS item in the ACR/EULAR criteria improves their diagnostic performance. Disclosure of Interest S. Jousse-Joulin: None declared, F. Gatineau: None declared, C. Baldini: None declared, S. Arends: None declared, F. Barone: None declared, A. Baer: None declared, H. Bootsma: None declared, S. Bowman: None declared, P. Brito-Zeron: None declared, D. Cornec: None declared, T. Dorner: None declared, S. De Vita: None declared, B. Fisher: None declared, D. Hammenfors: None declared, M. Jonsson: None declared, X. Mariette: None declared, V. Milic: None declared, T. Nakamura: None declared, W.-F. Ng: None declared, E. Nowak: None declared, A. Rasmussen: None declared, R. Seror: None declared, C. Shiboski: None declared, T. Nakamura: None declared, M. Ramos-Casals: None declared, A. Vissink: None declared, A. saraux: None declared, V. Devauchelle-Pensec Grant/research support from: ROCHE-CHUGAI