Proteomic Insights from Dried Blood Spots to Guide Leflunomide/Hydroxychloroquine Therapy: Towards At-Home Monitoring of primary Sjogren’s Disease 3516

Abstract Description Introduction Primary Sjogren’s disease (pSD) patients regularly experience periods of increased disease activity that often go unnoticed due to infrequent general checkups. To better monitor disease activity, dried blood spots (DBS) could help in assessing disease activity and progression more accurately. Our aim was to demonstrate if DBS proteomics can serve as a tool to monitor disease activity symptom scores and predict response to therapy. Methods In the RepurpSS-I trial, a DB-RCT with leflunomide/hydroxychloroquine combination vs placebo therapy for pSD patients, DBS (heparin blood collected at Whatman paper) and serum were obtained at baseline and after 24 weeks and compared to healthy controls (HC). Proteomic analysis of 368 analytes (inflammation panel) was performed using Olink. Results Significant correlations between DBS and serum were found for 17% and 18% of the proteins (ranging from r = 0.5-0.7 and r > 0.7, respectively). These included proteins associated with type I and II interferons (IFNs), correlating with IFN gene signatures. Many of these were upregulated in pSD vs HC. Various baseline DBS proteins (n = 35) significantly correlated with systemic disease- and patient-reported clinical outcome measures. In addition, changes in numerous proteins (n = 34) correlated with different clinical responses. Conclusion Dried blood spot proteomics could serve as a novel minimal-invasive tool to monitor disease activity and predict response to therapy in patients with pSD. Funding Sources ZonMW, ReumaNederland, AbbVie inc. Topic Categories Translational and Interventional Immunology (TI)