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Advancements in Sjögren’s Disease

CE / CME

Making Progress in Sjögren’s: Key Considerations for Improving Recognition, Disease Management, and the Potential of Emerging Therapies

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurse Practitioners: 1.00 Nursing contact hours, includes 1.00 hour of pharmacotherapy credit

Released: November 21, 2024

Expiration: November 20, 2025

R. Hal Scofield
R. Hal Scofield, MD
CME/CE Information

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Anti-Ro/SSA and Anti-La/SSB Antibody Tests

As mentioned earlier, the hallmark antibodies associated with Sjögren’s syndrome are anti‑Ro (also called SSA) and anti‑La (also called SSB). Approximately 75% of patients with Sjögren’s disease present with these antibodies.

However, these antibodies are also found in other autoimmune conditions, such as rheumatoid arthritis and lupus. Specifically, the anti‑52 Ro antibody is commonly found in patients with myositis, including polymyositis and rheumatoid myositis, and in those who also exhibit Raynaud’s phenomenon or interstitial lung disease. Some patients with systemic sclerosis may also have anti‑Ro antibodies. Furthermore, it is estimated that approximately 1% of otherwise healthy adult women test positive for anti‑Ro antibodies.

Therefore, the presence of these antibodies is neither sufficient nor necessary for a diagnosis of Sjögren’s syndrome, and thus should be considered a helpful but not definitive diagnostic marker.21-23

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Diagnostic Ultrasound

Diagnostic ultrasound of the salivary glands has been increasingly studied in Sjögren’s syndrome over recent years. However, its role in the diagnostic process remains unclear. Although there is a scoring system in place for evaluating these ultrasounds, and the scoring itself is relatively straightforward, its relevance to the diagnosis of the disease and its potential as a substitute for salivary gland biopsy has yet to be determined. Ongoing research is being conducted to better understand how ultrasound can be integrated into the diagnostic criteria for Sjögren’s syndrome.24

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Practical Utilization of Tests for Diagnosis

In summary, although the most definitive diagnostic test for Sjögren’s syndrome is a minor salivary gland biopsy, this test is primarily used in the clinical trial setting. In the clinic, diagnosis of Sjögren’s should be made based on expert opinion and fulfillment of classification criteria, rather than the results of a single test.

A positive anti-Ro/SSA and anti-La/SSB antibody test plus the presence of ocular and oral symptoms is often enough for a diagnosis of Sjögren’s syndrome. Diagnostic ultrasound of the major salivary glands can also be used as a complementary tool for diagnosis but should not be used as the primary diagnostic criteria.

There is also ongoing and intensive research focused on identifying potential salivary and ocular protein biomarkers of Sjögren’s syndrome, but more rigorous validation of these biomarkers is still needed.12-14,16

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