BackgroundPrimary Sjögren’s syndrome (pSS) is associated with an increased prevalence of traditional risk factors and cardiovascular diseases (CVDs).ObjectivesThe study aimed to identify specific risk factors for CVD in pSS patients.MethodsPSS patients with and without CVD were compared. All patients fulfilled the EULAR/ACR classification criteria. Patients with CVD presented at least one of the following manifestations: myocardial infarction, transient ischemic attacks, ischemic or hemorrhagic stroke, peripheral artery disease, coronary artery disease and carotid plaques. Data were collected by a standardized protocol and review of medical records.Results61/312 (19.6%) pSS patients presented with CVD. Traditional risk factors such as hypertension, hypercholesterinemia and diabetes (p<0.05), pSS manifestations, in particular vasculitis (p=0.033) and Raynaud’s phenomenon (p=0.018) were associated with CVD. Among patients with ischemic events (28/312, 9%), particularly cerebrovascular disease (n=12/28, 42.9%), correlations with increased EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI) (p=0.039) and EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI) (p=0.048) were observed. Age at first cerebrovascular event was 55.2 [48.9 – 69.6] years. Multivariate analysis confirmed hypertension (odds ratio (OR) 3.7, 95% confidence interval (CI) 1.87–7.18, p<0.001), hypercholesterinemia (OR 31 3.1, 95% CI 1.63–5.72, p<0.001), male gender (OR 0.4, 95% CI 0.17–0.78, p=0.009), Raynaud’s phenomenon (OR 2.5, 95% CI 1.28–4.82, p=0.007) and CNS involvement (OR 2.7, 95% CI 1.00–33 7.15, p=0.048) as independent CVD predictors.ConclusionRaynaud´s phenomenon as well as vasculitis and high ESSDAI have shown a significant association to CVD. PSS patients with cerebrovascular events were younger than expected. Knowledge about risk factors may help clinicians to identify pSS patients at risk for CVD. After diagnosis of pSS, patients should be screened for risk factors such as hypertension and receive appropriate therapy to prevent or at least reduce sequelae such as infarction. However, further investigations are necessary in order to achieve a reliable risk stratification for these patients.AcknowledgementsWe would like to express our gratitude to the staff of the Rheumatology Outpatients Department at Hannover Medical School for their continual help in organization of patients Reference styles.Disclosure of InterestsNone Declared.

BackgroundSjögren’s Syndrome is well known for its characteristic sicca symptoms due to autoinflammatory destruction of the salivary and lacrymal glands, but neurological involvement is also common in this entity. Nevertheless, previously published smaller studies suggested distinct clinical features for Sjögren’s syndrome with and without neurological involvement, such as a more balanced gender distribution and lower IgG levels in patients with Sjögren‘ syndrome and neurological involvement1,2.ObjectivesWe therefore aimed to systematically assess clinical features of patients with Sjögren’s syndrome with and without neurological involvement, find relevant in-between group differences and hereby aid early detection of both patient groups in the clinical routine to facilitate further studies, potentially with new therapeutic approaches.MethodsWe retrospectively assessed patients with Sjögren’s syndrome treated at the neurological and rheumatological/ immunological departement of our university hospital between 05/2014 and 09/2021 for available laboratory and clinical data. The displayed data represent preliminary results of this ongoing study.Results405 patients, who fulfilled the current ACR/EULAR classification criteria for Sjögren’s syndrome3 were currently included in the study (median age 59years [IQR 50-70 years], median ESSDAI 10 [IQR 3-16]). 228 patients (56%) showed neurological involvement. They were significantly more often male (32% vs. 14%; p<0.001) and showed lower IgG serum levels (median 11 g/l [IQR 9-13 g/l] vs 12 g/l [IQR 10-16 g/l], p<0.01) in comparison to patients with Sjögren’s syndrome but without neurological involvement. However, presence of objective xerostomia, objective xerophthalmia, SSA(Ro)-antibody-positivity or sialadenits grade 3 or 4 (Chisholm and Mason) on salivary gland biopsy did not differ between the two groups.ConclusionPreliminary analysis of this ongoing study supports the hypothesis, that patients with Sjögren’s syndrome and neurological impairment might express a distinct clinical phenotype in comparison to patients with Sjögren’s syndrome but without neurological involvement.References[1]Sjögren’s syndrome should be considered in patients with motor neuropathy. Zeitschrift fur Rheumatologie 2020; 79: 707–709.[2]Seeliger T, Prenzler NK, Gingele S, et al. Neuro-Sjögren: Peripheral neuropathy with limb weakness in Sjögren’s syndrome. Front Immunol 2019; 10: 1600.[3]Shiboski CH, Shiboski SC, Seror R, et al. 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjögren’s syndrome. Ann Rheum Dis 2017; 76: 9–16.Disclosure of InterestsTabea Seeliger: None declared, Emelie Kramer: None declared, Franz F. Konen: None declared, Sonja Beider: None declared, Alexandra Jablonka: None declared, Torsten Witte: None declared, Thomas Skripuletz Employee of: Honoraria for lectures: Alexion, Alnylam, Bayer Vital, Biogen, Celgene, CSL Behring, Euroimmun, Janssen, Merck Serono, Novartis, Pfizer, Roche, Sanofi, Siemens, Diana Ernst Consultant of: Participation in Advisory Boards: Abbvie, Galapagos, Amgen, Novartis, Employee of: Fees for Presentations: Abbvie, Amgen, BMS, Chugai, Cilag-Janssen, Galapagos, GSK, Medac, Lilly, Pfizer, Novartis, Roche