E123 Tracking the course of Sjögren’s disease through serological markers: a 40-year follow-up cohort

Abstract Background/Aims Sjögren disease (SjD) is a chronic, autoimmune rheumatic disorder characterised by lymphocytic infiltration of exocrine glands. Dry mouth and eyes, pain and fatigue are the three main symptoms, present in 80% of patients. However, in 30-40% patients, SjD has systemic manifestations. The most characteristic autoantibodies are anti-Ro/SSA (positive in 50-75%) and anti-La/SSB antibodies (positive in up to 50%). Other abnormalities include anti-nuclear antibodies (ANA) (positive in 80%), rheumatoid factor (RF) (positive in 50%) and hypergammaglobulinemia (in about 30%). Methods We performed a retrospective observational study of patients with SjD (2016 ACR/EULAR criteria for SjD) at University College London Hospital (1982-2025). Data on demographic characteristics, clinical features, and serological markers were obtained from paper and electronic health records. Associations between lymphoma and selected variables were analysed using Chi-square or Fisher’s exact tests; relative risks (RR) with 95% confidence intervals (CI) were calculated. A p 0.05 was considered significant. Results Of the 283 patients, 93.3% were female with a mean age at diagnosis of 50.1 ± 15.2 years. Parotid enlargement was the most frequent glandular feature (n = 82, 30.5%), and arthritis the main systemic manifestation (n = 73, 25.8%). ANA was positive in 87.4% (n = 235; speckled pattern in n = 195, 83.7%). Anti-Ro (n = 106, 75.7%), Anti-La (n = 132, 45.2%), rheumatoid factor (n = 150, 57.3%), and hypergammaglobulinemia (n = 136, 52.5%) were also frequent. Overall mortality was 18.6% (n = 48), mainly due to infection (n = 11, 34.4%) and lymphoma (n = 4, 12.5%). Table 1 summarises the associations between serological markers with clinical features. Conclusion Anti-Ro positivity was associated with parotid swelling, lymphadenopathy, and vasculitis, but less Raynaud’s phenomenon. Anti-La positivity correlated with parotid swelling, lymphadenopathy, and lung impairment, but less peripheral nervous system involvement. RF-positive patients showed more parotid swelling, lymphadenopathy, arthritis, ulcers, vasculitis, and lung impairment. Hypergammaglobulinemia correlated with parotid swelling, lymphadenopathy, vasculitis, and reduced peripheral nervous system involvement. No differences were seen in fatigue or liver impairment across groups. These results indicate distinct clinical patterns linked to antibody status and gammaglobulin levels. Disclosure M. Angerri-Nadal: None. U. Couto-Lareo: None. B. Viejo-Sosa: None. D.A. Isenberg: None.