Pos1455 interstitial lung disease in sjogren’s syndrome: prevalence, patterns, treatment, and prognosis

Background Interstitial lung disease (ILD) is a potentially serious yet underdiagnosed manifestation of primary Sjogren’s syndrome (pSS). Objectives This observational study aimed to investigate the clinical, functional, and imaging characteristics of ILD in pSS, together with treatment and prognosis. Methods Longitudinal clinical and laboratory data of patients with pSS were extracted from three hospitals of the Catholic Medical Center through a clinical data warehouse, between March 1, 2012, and February 28, 2022. Predisposing factors for the development of ILD and acute exacerbation were identified using a logistic regression model. Results A total of 1,402 patients with pSS were included in this study (Female, 98%; median age, 55 years). Among them, 92 patients with pSS (7%) were comorbid with ILD (21 biopsy-proven cases). Fibrosing nonspecific interstitial pneumonia (NSIP) was the most prevalent CT pattern in pSS-ILD (58%), followed by usual interstitial pneumonia (20%), and organizing pneumonia (16%). At the diagnosis with pSS-ILD, 64% of patients showed reduced diffusion capacity, and 54.3% of patients with pSS-ILD showed a restrictive functional pattern. The median follow-up period was 3.2 years. During follow-up, six patients died (6.5%) and 26 patients (28.3%) experienced acute exacerbation (AE). However, 64% of patients showed no AE without treatment. Lower baseline forced vital capacity (FVC) (Odds ratio (OR), 0.962, P = 0.026) and high neutrophil-to-lymphocyte ratio (OR, 3.59, P = 0.046) were significant predisposing factors for AE. Conclusion ILD accounted for 7% of the comorbidity of SS, and 64% showed stable lung function without treatment. AE was associated with NLR and baseline FVC. References [1]Flament T, Bigot A, Chaigne B, Henique H, Diot E, Marchand-Adam S: Pulmonary manifestations of Sjögren’s syndrome. Eur Respir Rev 2016, 25(140):110-123. [2]Mikolasch TA, George PM, Sahota J, Nancarrow T, Barratt SL, Woodhead FA et al. Multi-center evaluation of baseline neutrophil-to-lymphocyte (NLR) ratio as an independent predictor of mortality and clinical risk stratifier in idiopathic pulmonary fibrosis. EClinicalMedicine. 2022 Dec 1;55:101758. [3]Kim YJ, Choe J, Kim HJ, Song JW. Long-term clinical course and outcome in patients with primary Sjogren syndrome-associated interstitial lung disease. Sci Rep. 2021;11(1):12827. Acknowledgements: NIL. Disclosure of Interests None Declared.