POS0266 DEVELOPMENT OF AN ARTICULAR SCORE IN SYSTEMIC SCLEROSIS (ASSESS): IDENTIFICATION OF CORE INSTRUMENTS TO ASSESS DISEASE ACTIVITY

Background: Inflammatory joint and tendon involvement resulting in pain and reduced joint function affects up to 30% of patients with systemic sclerosis (SSc) and represents a major burden on patient quality of life. The lack of standardized outcome measurements for assessing articular involvement in SSc not only limits the development of evidence-based therapies, but also results in incomplete clinical picture of joint involvement in SSc. Objectives: We aimed at identifying core instruments for the development of a consensus-based multi-outcome domain: the Articular Score in SystEmic ScleroSis (ASSESS) to assess articular activity among SSc patients for use in both clinical practice and trials. Methods: A steering committee comprising of 12 rheumatologists, 1 epidemiologist, 1 occupational therapist, and 3 patient research partners, was convened. The articular score was developed through a stepwise iterative process (Figure 1). First, a dedicated scoping review was conducted in PubMed/Medline (January 1960 to April 2023), where two reviewers independently identified eligible studies assessing joint and tendon involvement in SSc and extracted the instruments used to assess outcomes. After expert opinion discussion, instruments were selected if they were considered both feasible and valid by at least 70% of the steering committee. Selected instruments were further assessed by two independent reviewers using OMERACT filters. The results were presented to the steering committee and after a 2-step online Delphi survey, final core instruments to assess articular activity in SSc patients were defined. Results: Among a total of 770 identified references, 658 were excluded based on their title and/or abstract resulting in 112 articles being examined based on the full text (Figure 1). Overall, 82 studies were included, of which 43 instruments that were used for assessing articular activity in at least two studies were identified. Based on domain match and feasibility, 9 clinical, 1 laboratory, 3 clinico-biological and 3 patient-reported outcomes (Table 1) were selected for consideration in the articular activity score. Based on the measurement property analysis according to OMERACT guidelines, the steering committee voted and selected the 6 instruments to be included in the composite score to assess joint and tendon activity in SSc patients. The ASSESS score will comprise: clinical (tender and swollen joint count, standard 28 joints with the addition of distal interphalangeal joints; the presence of tendon friction rubs), serological (CRP), and patient and physician reported outcome measurements (VAS activity pain patient, VAS activity doctor) instruments. Conclusion: The steering committee identified 6 meaningful core instruments to assess articular activity in SSc patients. This represents the foundation for further development of a composite score for joint and tendon involvement in SSc for use in both clinical practice and trials. In the subsequent steps, we plan to obtain weight for individual instruments within longitudinal SSc cohorts using the presence of activity in ultrasound and a patient-reported questionnaire (Likert scale 1-5) as anchors. Figure 1Scoping review search strategy. REFERENCES: NIL . Table 1Identified core instruments for assessing disease articular activity in SSc patients.ClinicalSerologyClinico-biological scorePatient reported outcomes○ Ritchie articular index○ Number of tender joints○ Number of swollen joints○ Number of synovitis○ Presence of tendon friction rubs○ Number of tendon frictions rubs○ CRP○ DAS28-ESR○ DAS28-CRP○ SDAI○ Visual analogic scale for articular pain (patient)○ Visual analogic scale for disease activity (patient)○ Visual analogic scale for disease activity (physician) Acknowledgements: NIL . Disclosure of Interests: Blaž Burja: None declared , Paco M.J. Welsing: None declared , Alain Lescoat: None declared , Andreas Eisenring: None declared , Anna-Maria Hoffmann-Vold Boehringer Ingelheim, Janssen, Medscape, Merck Sharp & Dohme, Novartis and Roche, AbbVie, ARXX, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Janssen, Medscape, Merck Sharp & Dohme, Pliant Therapeutics, Roche and Werfen, Boehringer Ingelheim, Janssen, Claire Leroy David: None declared , Dinesh Khanna: None declared , Francesco Del Galdo: None declared , Michele Iudici: None declared , Janet Pope: None declared , Julia Spierings: None declared , Madelon Vonk: None declared , Marie-Elise Truchetet AbbVie, Boehringer Ingelheim, Janssen, Lilly, MSD, and UCB, Martine Clergeau: None declared , Michael Hughes: None declared , Susan L Murphy: None declared , Tracy Frech: None declared , Oliver Distler 4P-Pharma, Abbvie, Acceleron, Acepodia Biotech, Aera, Alcimed, Altavant, Amgen, AnaMar, Anaveon AG, Argenx, AstraZeneca, Blade, Bayer, Boehringer Ingelheim, Calluna (Arxx), Cantargia AB, Catalyze Capital, Corbus, CSL Behring, Galderma, Galapagos, Glenmark, Gossamer, Horizon, Janssen, Kymera, Lupin, Medscape, MSD Merck, Miltenyi Biotec, Mitsubishi Tanabe, Nkarta Inc., Novartis, Orion, Pilan, Prometheus, Quell, Redxpharma, Roivant, EMD Serono, Topadur and UCB, Co-founder of CITUS AG, 4P-Pharma, Abbvie, Acceleron, Acepodia Biotech, Aera, Alcimed, Altavant, Amgen, AnaMar, Anaveon AG, Argenx, AstraZeneca, Blade, Bayer, Boehringer Ingelheim, Calluna (Arxx), Cantargia AB, Catalyze Capital, Corbus, CSL Behring, Galderma, Galapagos, Glenmark, Gossamer, Horizon, Janssen, Kymera, Lupin, Medscape, MSD Merck, Miltenyi Biotec, Mitsubishi Tanabe, Nkarta Inc., Novartis, Orion, Pilan, Prometheus, Quell, Redxpharma, Roivant, EMD Serono, Topadur and UCB, BI, Kymera, Mitsubishi Tanabe, UCB, Muriel Elhai Boehringer Ingelheim, Pfizer, Novartis Foundation for Bio-Medical Research. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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