{
  "abstract": "Introduction Inflammatory joint and tendon involvement affects up to 30% of patients with systemic sclerosis (SSc), resulting in pain, reduced joint function, and impaired patients’ quality of life. The lack of standardized outcome measures for assessing articular activity in SSc limits the development of evidence-based therapies and results in incomplete clinical data. To address this gap, we aimed to develop a consensus-based composite score to assess articular activity in SSc, designed for use in clinical practice and clinical trials.Material and Methods A steering committee was convened, consisting of 12 rheumatologists, 1 epidemiologist, 1 occupational therapist, and 3 patient research partners. The development of the articular activity score followed a stepwise process ( figure 1). First, a scoping review was conducted using PubMed/MEDLINE (January 1960 to April 2023), where two independent reviewers screened studies evaluating joint and tendon involvement in systemic sclerosis (SSc) and extracted relevant assessment outcomes. Following expert discussions, instruments demonstrating at least 70% validity and feasibility after the committee voting were further evaluated by two independent reviewers according to OMERACT (Outcome Measures in Rheumatology) guidelines. These findings were then presented to the steering committee, and through a two-step online Delphi survey, a final set of core instruments for assessing articular activity in SSc was identified.Results Of the 770 references initially identified, 658 were excluded based on title or abstract screening, leaving 112 articles for full-text review; ultimately, 86 studies met the inclusion criteria. From these, 46 instruments that were used in at least two studies were identified. Based on domain validity and feasibility, 9 clinical, 1 laboratory, 3 clinical-biological, and 3 patient-reported outcome measures were shortlisted for further evaluation ( table 1). Following an assessment of measurement properties according to OMERACT guidelines, the steering committee voted and selected 6/16 instruments for inclusion in a composite outcome measure to assess articular activity in patients with SSc. In particular, the instruments selected covered the clinical (tender and swollen joint count in standard 28 joints with the addition of distal interphalangeal joints; the presence of tendon friction rubs), serological (CRP) and patient/physician reported outcomes (VAS activity pain patient, VAS activity doctor) domains.Conclusions The preliminary phase of our project identified 6 meaningful core instruments to assess articular activity in SSc patients, covering both joint and tendon involvement. This represents the foundation for further development of a composite score for articular involvement in SSc for use in clinical practice and clinical trials.Abstract P.408 Figure 1Scoping review search strategyAbstract P.408 Table 1Identified instruments for assessing disease acitvity",
  "authors": [
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Blaz Burja"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, * OTHER"
      ],
      "name": "Paco Welsing Welsing"
    },
    {
      "affiliations": [
        "Internal Medicine & Clinical Immunology, CHU Rennes, Rennes, France"
      ],
      "name": "Alain Lescoat"
    },
    {
      "affiliations": [
        "Patient research partners, * OTHER"
      ],
      "name": "Andreas Eisenring"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Anna-Maria Hofmann-Vold"
    },
    {
      "affiliations": [
        "Patient research partners, * OTHER"
      ],
      "name": "Claire Leroy David"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, University of Michigan, Ann Arbor, Michingan, USA"
      ],
      "name": "Dinesh Khanna"
    },
    {
      "affiliations": [
        "Leeds Institute of Rheumatic and Musculoskeletal Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK"
      ],
      "name": "Francesco Del Gardo"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Iudici Michele"
    },
    {
      "affiliations": [
        "Department of Medicine, University of Western Ontario, Ontario, Canada"
      ],
      "name": "Janet Pope"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht,, Utrecht, * OTHER"
      ],
      "name": "Julia Spierings"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Radbound University Medical Centre, Nijmegen,, * OTHER"
      ],
      "name": "Madelon Vonk"
    },
    {
      "affiliations": [
        "Rheumatology Department, CHU Bordeaux Hospital, Bordeaux, France"
      ],
      "name": "Marie-Elise Trucetet"
    },
    {
      "affiliations": [
        "Patient research partners, * OTHER"
      ],
      "name": "Martine Clergeau"
    },
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust, Salford Care Organisation, Salford, UK",
        "Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester Academic Health Scienc, Manchester, UK"
      ],
      "name": "Michael Hughes"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, University of Michigan, Ann Arbor, Michingan, USA"
      ],
      "name": "Susan Murphy"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Division of Rheumatology and Immunology, Tennessee Valley Health Care System, Veterans, Tennessee, USA"
      ],
      "name": "Tracy Frech"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Oliver Distler"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Muriel Elhai"
    }
  ],
  "title": "P.408 Development of an articular activity score in systemic sclerosis (assess): identifying core instruments for disease activity assessment",
  "uid": "4062a940-5d56-519c-ac54-494399b5e767"
}