Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren’s disease

Objectives The objectives are to evaluate variation in systemic disease activity (European Alliance of Associations For Rheumatology (EULAR) Sjögren’s Syndrome Disease Activity Index (ESSDAI)) over time at group and individual patient level and to assess associations of ESSDAI low disease activity (...

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Main Authors: Suzanne Arends, Arjan Vissink, Hendrika Bootsma, Liseth de Wolff, Gwenny Verstappen, Alja Stel, Greetje van Zuiden, Jolien van Nimwegen, Frans Kroese
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/11/1/e004753.full
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author Suzanne Arends
Arjan Vissink
Hendrika Bootsma
Liseth de Wolff
Gwenny Verstappen
Alja Stel
Greetje van Zuiden
Jolien van Nimwegen
Frans Kroese
author_facet Suzanne Arends
Arjan Vissink
Hendrika Bootsma
Liseth de Wolff
Gwenny Verstappen
Alja Stel
Greetje van Zuiden
Jolien van Nimwegen
Frans Kroese
author_sort Suzanne Arends
collection DOAJ
description Objectives The objectives are to evaluate variation in systemic disease activity (European Alliance of Associations For Rheumatology (EULAR) Sjögren’s Syndrome Disease Activity Index (ESSDAI)) over time at group and individual patient level and to assess associations of ESSDAI low disease activity (LDA) with other outcome measures in a standard-of-care cohort of patients with Sjögren’s disease (SjD).Methods Patients with SjD participating in a prospective longitudinal study (REgistry of Sjögren Syndrome LongiTudinal cohort) fulfilling the 2016 American College of Rheumatology/EULAR classification criteria with ≥2 years of follow-up were included. ESSDAI was assessed at least yearly, up to 5 years. Patient-reported, objective glandular and laboratory outcomes were compared between patients with ESSDAI LDA (score<5) for <75% vs ≥75% of time.Results Of 265 included patients with SjD, 236 (89%) were women, median disease duration was 6 years (IQR 2–10) and 114 (43%) received immunosuppressive treatment at some point during follow-up. At group level, median ESSDAI decreased slightly, from 4 (IQR 2–7) at baseline to 3 (IQR 2–5) at year 5, with a concomitant decrease in variation, indicating regression to the mean. At the individual patient level, ESSDAI varied in the majority of patients: 50/102 (49%) untreated patients with ESSDAI<5 at baseline changed to ESSDAI≥5 at least once during follow-up. Of the untreated patients with ESSDAI≥5 at baseline, 41/45 (91%) changed to ESSDAI<5. Patients with ESSDAI LDA for ≥75% of time showed better outcomes on saliva production.Conclusions In this cohort of patients with SjD, overall ESSDAI slightly decreased during 5 years of follow-up, whereas at individual patient level, large variation was seen over time for the majority of patients. Longer time in ESSDAI LDA was associated with better salivary gland outcomes.
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spelling doaj-art-8cc7a2b55c4348a19f9562d7fb4cf2f02025-01-23T07:35:11ZengBMJ Publishing GroupRMD Open2056-59332025-01-0111110.1136/rmdopen-2024-004753Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren’s diseaseSuzanne Arends0Arjan Vissink1Hendrika Bootsma2Liseth de Wolff3Gwenny Verstappen4Alja Stel5Greetje van Zuiden6Jolien van Nimwegen7Frans Kroese8Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Groningen, The NetherlandsOral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The NetherlandsRheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Groningen, The NetherlandsRheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Groningen, The NetherlandsRheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Groningen, The NetherlandsRheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Groningen, The NetherlandsRheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Groningen, The NetherlandsRheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Groningen, The NetherlandsRheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Groningen, The NetherlandsObjectives The objectives are to evaluate variation in systemic disease activity (European Alliance of Associations For Rheumatology (EULAR) Sjögren’s Syndrome Disease Activity Index (ESSDAI)) over time at group and individual patient level and to assess associations of ESSDAI low disease activity (LDA) with other outcome measures in a standard-of-care cohort of patients with Sjögren’s disease (SjD).Methods Patients with SjD participating in a prospective longitudinal study (REgistry of Sjögren Syndrome LongiTudinal cohort) fulfilling the 2016 American College of Rheumatology/EULAR classification criteria with ≥2 years of follow-up were included. ESSDAI was assessed at least yearly, up to 5 years. Patient-reported, objective glandular and laboratory outcomes were compared between patients with ESSDAI LDA (score<5) for <75% vs ≥75% of time.Results Of 265 included patients with SjD, 236 (89%) were women, median disease duration was 6 years (IQR 2–10) and 114 (43%) received immunosuppressive treatment at some point during follow-up. At group level, median ESSDAI decreased slightly, from 4 (IQR 2–7) at baseline to 3 (IQR 2–5) at year 5, with a concomitant decrease in variation, indicating regression to the mean. At the individual patient level, ESSDAI varied in the majority of patients: 50/102 (49%) untreated patients with ESSDAI<5 at baseline changed to ESSDAI≥5 at least once during follow-up. Of the untreated patients with ESSDAI≥5 at baseline, 41/45 (91%) changed to ESSDAI<5. Patients with ESSDAI LDA for ≥75% of time showed better outcomes on saliva production.Conclusions In this cohort of patients with SjD, overall ESSDAI slightly decreased during 5 years of follow-up, whereas at individual patient level, large variation was seen over time for the majority of patients. Longer time in ESSDAI LDA was associated with better salivary gland outcomes.https://rmdopen.bmj.com/content/11/1/e004753.full
spellingShingle Suzanne Arends
Arjan Vissink
Hendrika Bootsma
Liseth de Wolff
Gwenny Verstappen
Alja Stel
Greetje van Zuiden
Jolien van Nimwegen
Frans Kroese
Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren’s disease
RMD Open
title Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren’s disease
title_full Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren’s disease
title_fullStr Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren’s disease
title_full_unstemmed Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren’s disease
title_short Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren’s disease
title_sort systemic disease activity measured with essdai varies largely over 5 years in a prospective longitudinal cohort of patients with sjogren s disease
url https://rmdopen.bmj.com/content/11/1/e004753.full
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