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Discriminative power of salivary gland ultrasound in relation to symptom-based endotypes in suspected and definite primary Sjögren's Syndrome

Liselotte Deroo (UGent) , Helena Achten (UGent) , Kristel De Boeck (UGent) , Eva Genbrugge (UGent) , Wouter Bauters (UGent) , Dimitri Roels (UGent) , Frederick Dochy, David Creytens (UGent) , Ann-Sophie De Craemer (UGent) , Filip Van den Bosch (UGent) , et al.
(2022) SEMINARS IN ARTHRITIS AND RHEUMATISM. 56.
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Abstract
Objectives: Salivary gland ultrasound (SGUS) is emerging as essential tool in primary Sjögren's Syndrome (pSS), but its link to symptom-based endotypes is unknown. Therefore, we explored SGUS outcomes in relation to endotypes in patients with definite and suspected pSS. Methods: Definite pSS patients (n = 171) fulfilling the 2016 ACR/EULAR classification criteria, and suspected pSS patients (n = 119), positive for at least one criterion, were included in the Belgian Sjögren's Syndrome Transition Trial (BeSSTT). Stratification into endotypes according to the Newcastle Sjögren's Stratification Tool resulted in low symptom burden (LSB), pain dominant with fatigue (PDF), dryness dominant with fatigue (DDF) and high symptom burden (HSB). SGUS was assessed with Hocevar score (0-48). The dataset was randomly divided into a discovery (n = 203) and replication (n = 87) cohort. Results: SGUS had strong discriminative power for pSS classification (AUC=0.74), especially in DDF (AUC=0.89). In definite pSS, Hocevar scores in DDF were high compared to other endotypes (38 (20-44) versus 18 (9-33); p < 0.001). Patients with highest SGUS-scores showed more sicca and laboratory abnormalities. Moreover, a subset of young, anti-SSA/Ro positive patients not fulfilling classification criteria showed clear SGUS abnormalities. Replication showed similar results. Conclusions: SGUS-scores were significantly higher in definite pSS with DDF endotype, providing the first evidence of imaging abnormalities in salivary glands matching distinct biological profiles ascribed to pSS endotypes. Additionally, a subset of patients with potential early disease was detected based on presence of anti-SSA antibodies and high SGUS-scores. These results underscore the role of SGUS as powerful tool both in pSS classification and stratification.

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MLA
Deroo, Liselotte, et al. “Discriminative Power of Salivary Gland Ultrasound in Relation to Symptom-Based Endotypes in Suspected and Definite Primary Sjögren’s Syndrome.” SEMINARS IN ARTHRITIS AND RHEUMATISM, vol. 56, 2022, doi:10.1016/j.semarthrit.2022.152075.
APA
Deroo, L., Achten, H., De Boeck, K., Genbrugge, E., Bauters, W., Roels, D., … Peene, I. (2022). Discriminative power of salivary gland ultrasound in relation to symptom-based endotypes in suspected and definite primary Sjögren’s Syndrome. SEMINARS IN ARTHRITIS AND RHEUMATISM, 56. https://doi.org/10.1016/j.semarthrit.2022.152075
Chicago author-date
Deroo, Liselotte, Helena Achten, Kristel De Boeck, Eva Genbrugge, Wouter Bauters, Dimitri Roels, Frederick Dochy, et al. 2022. “Discriminative Power of Salivary Gland Ultrasound in Relation to Symptom-Based Endotypes in Suspected and Definite Primary Sjögren’s Syndrome.” SEMINARS IN ARTHRITIS AND RHEUMATISM 56. https://doi.org/10.1016/j.semarthrit.2022.152075.
Chicago author-date (all authors)
Deroo, Liselotte, Helena Achten, Kristel De Boeck, Eva Genbrugge, Wouter Bauters, Dimitri Roels, Frederick Dochy, David Creytens, Ann-Sophie De Craemer, Filip Van den Bosch, Dirk Elewaut, and Isabelle Peene. 2022. “Discriminative Power of Salivary Gland Ultrasound in Relation to Symptom-Based Endotypes in Suspected and Definite Primary Sjögren’s Syndrome.” SEMINARS IN ARTHRITIS AND RHEUMATISM 56. doi:10.1016/j.semarthrit.2022.152075.
Vancouver
1.
Deroo L, Achten H, De Boeck K, Genbrugge E, Bauters W, Roels D, et al. Discriminative power of salivary gland ultrasound in relation to symptom-based endotypes in suspected and definite primary Sjögren’s Syndrome. SEMINARS IN ARTHRITIS AND RHEUMATISM. 2022;56.
IEEE
[1]
L. Deroo et al., “Discriminative power of salivary gland ultrasound in relation to symptom-based endotypes in suspected and definite primary Sjögren’s Syndrome,” SEMINARS IN ARTHRITIS AND RHEUMATISM, vol. 56, 2022.
@article{8763630,
  abstract     = {{Objectives: Salivary gland ultrasound (SGUS) is emerging as essential tool in primary Sjögren's Syndrome (pSS), but its link to symptom-based endotypes is unknown. Therefore, we explored SGUS outcomes in relation to endotypes in patients with definite and suspected pSS.

Methods: Definite pSS patients (n = 171) fulfilling the 2016 ACR/EULAR classification criteria, and suspected pSS patients (n = 119), positive for at least one criterion, were included in the Belgian Sjögren's Syndrome Transition Trial (BeSSTT). Stratification into endotypes according to the Newcastle Sjögren's Stratification Tool resulted in low symptom burden (LSB), pain dominant with fatigue (PDF), dryness dominant with fatigue (DDF) and high symptom burden (HSB). SGUS was assessed with Hocevar score (0-48). The dataset was randomly divided into a discovery (n = 203) and replication (n = 87) cohort.

Results: SGUS had strong discriminative power for pSS classification (AUC=0.74), especially in DDF (AUC=0.89). In definite pSS, Hocevar scores in DDF were high compared to other endotypes (38 (20-44) versus 18 (9-33); p < 0.001). Patients with highest SGUS-scores showed more sicca and laboratory abnormalities. Moreover, a subset of young, anti-SSA/Ro positive patients not fulfilling classification criteria showed clear SGUS abnormalities. Replication showed similar results.

Conclusions: SGUS-scores were significantly higher in definite pSS with DDF endotype, providing the first evidence of imaging abnormalities in salivary glands matching distinct biological profiles ascribed to pSS endotypes. Additionally, a subset of patients with potential early disease was detected based on presence of anti-SSA antibodies and high SGUS-scores. These results underscore the role of SGUS as powerful tool both in pSS classification and stratification.}},
  articleno    = {{152075}},
  author       = {{Deroo, Liselotte and Achten, Helena and De Boeck, Kristel and Genbrugge, Eva and Bauters, Wouter and Roels, Dimitri and Dochy, Frederick and Creytens, David and De Craemer, Ann-Sophie and Van den Bosch, Filip and Elewaut, Dirk and Peene, Isabelle}},
  issn         = {{0049-0172}},
  journal      = {{SEMINARS IN ARTHRITIS AND RHEUMATISM}},
  language     = {{eng}},
  pages        = {{5}},
  title        = {{Discriminative power of salivary gland ultrasound in relation to symptom-based endotypes in suspected and definite primary Sjögren's Syndrome}},
  url          = {{http://doi.org/10.1016/j.semarthrit.2022.152075}},
  volume       = {{56}},
  year         = {{2022}},
}
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