Sjogren's SyndromeUltraSjögrenNCT06338735
Ultra-High Frequency Ultrasonography in Sjögren's Syndrome
A study testing Ultra-High Frequency Ultrasound scan of minor salivary glands in people with Sjogren's Syndrome, run by University of Pisa at 1 site in Italy.
Trial summary
Patients diagnosed with a diagnosis of Sjogren's syndrome performed according to the ACR/EULAR criteria will be included in the study. Sjogren's syndrome diagnosis will be performed following a complete diagnostic work-up involving rheumatologic assessment, glandular functional tests, and blood testing for… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Sjogren's Syndrome
- What is being tested?
- Ultra-High Frequency Ultrasound scan of minor salivary glands
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 800 participants
- Where
- 1 siteItaly
- Study dates
- 11 Jan 2016to Dec 2030
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- adults ≥ 18 years of age
- clinical suspect of Sjogren\'s syndrome
- acceptance to undergo complete Sjogren\'s Syndrome diagnostic work-up
- acceptance to be included in the study.
Who cannot join
- pregnancy or breastfeeding
- any acute or chronic condition that would limit the ability of the patient to participate in the study
- refusal to give informed consent
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Italy1 site, 1 recruiting
- Recruiting
University of Pisa
Pisa, 56126
Rossana Izzetti, +39050993037, rossana.izzetti@unipi.it
Rossana Izzetti
About this study
Official title: Ultra-High Frequency Ultrasonography (UHFUS) Evaluation of Salivary Glands in Patients With Suspected Sjögren's Syndrome
Patients diagnosed with a diagnosis of Sjogren's syndrome performed according to the ACR/EULAR criteria will be included in the study. Sjogren's syndrome diagnosis will be performed following a complete diagnostic work-up involving rheumatologic assessment, glandular functional tests, and blood testing for anti-Ro(SSA) antibodies. Conventional ultrasonography of major salivary glands and ultra-high frequency ultrasonography (70 MHz) of minor salivary glands will be performed, and the scans assessed using the Outcome Measures in Rheumatology (OMERACT) scoring system (Score 0 normal glandular tissue, Score 1 mild glandular alteration, fine echogenicity or diffuse hypo-echogenicity, Score 2 moderate glandular alteration and focal hypoechoic areas with partial conservation of normal parenchyma, Score 3 diffuse presence of hypoechoic areas in the absence of normal glandular parenchyma with glandular fibrosis. Focus Score will be assessed following biopsy of minor salivary glands.
Read the detailed description
Primary Sjögren's syndrome is a complex autoimmune disease involving the exocrine salivary and lachrymal glands, with a progressive functional impairment caused by lymphocytic infiltration in the glandular tissue. The diagnosis is currently performed according to the criteria established in 2016 by the American College of Rheumatologists/European League Against Rheumatism (ACR/EULAR) and relies on 5 items, namely i) histologic Focus Score (FS) ≥1, ii) positivity to Anti-SSA (Ro) antibodies, iii) Ocular staining score ≥ 5 (or van Bijsterfeld score ≥ 4) on at least one eye, iv) Schirmer test ≤ 5 mm/5min on at least one eye and v) Unstimulated Salivary Flow Rate (USFR) ≤ 0.1 ml/min. Focus Score and positivity to antibodies are items with a weight of 3 points each, while the other items are assigned score 1. Diagnosis is performed with a total score ≥ 4 when summing the weights. While the improvement in the sensitivity of ACR/EULAR classification criteria by 5-10% has been previously reported for ultrasonography of major salivary glands, at present no evidence is available for minor salivary glands. Minor salivary glands ultrasonography with the use of ultra-high frequencies up to 70 MHz has been recently introduced in the diagnostic work-up of Sjögren's syndrome, and involves the assessment of glandular ultrasonographic structural alterations through the application of the Outcome Measures in Rheumatology (OMERACT) scoring system, which is routinely used for major salivary glands. The present study therefore aims to assess the correlation between minor salivary glands ultrasonography and ACR/EULAR items, in order to evaluate whether this technique may integrate the current evaluation of Sjögren's syndrome patients.
- Conditions
- Sjogren's Syndrome
- Being tested
- Ultra-High Frequency Ultrasound scan of minor salivary glands
- Keywords
- ultra-high frequency ultrasonography, diagnostic imaging, Sjogren's syndrome, salivary glands
- Medical subject headings
- Sjogren's Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ultra-High Frequency Ultrasound scan of minor salivary glandsOther
Patients will undergo ultra-high frequency ultrasonography (70 MHz) of minor salivary glands, and the scans will be assessed using the OMERACT scoring system. Score 0 will be assigned in the presence of normal glandular tissue, Score 1 will correspond to mild glandular alteration, fine echogenicity or diffuse hypo-echogenicity, Score 2 will be assigned to moderate glandular alteration and focal hypoechoic areas with partial conservation of normal parenchyma, while in Score 3 diffuse presence of hypoechoic areas in the absence of normal glandular parenchyma with glandular fibrosis will be observed.
| Study group | Role | What they receive |
|---|---|---|
| Sjogren's syndrome | Experimental | patients with Sjogren's syndrome diagnosed according to the ACR/EULAR criteria Receives: Other: Ultra-High Frequency Ultrasound scan of minor salivary glands |
What is being measured
The primary outcome is the main question the study is designed to answer.
OMERACT score
Evaluation of ultrasonographic scans with the Outcome Measures in Rheumatology (OMERACT) scoring system, ranging between Score 0 (normal glandular tissue) and 3 (diffuse presence of hypoechoic areas in the absence of normal glandular parenchyma with glandular fibrosis )
Measured: 1 month
Correspondence between ultrasonography and histology
Evaluation of the concordance between ultrasonographic score of minor salivary glands assessed with Outcome Measures in Rheumatology (OMERACT) scoring system (scores 0-3) and histology
Measured: 1 month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Apr 2024
- Study start11 Jan 2016
- Primary completion31 Dec 2026 (estimated)
- Study completionDec 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Sjogren's SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 800 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Pisa
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Rossana Izzetti, University of Pisa
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06338735
- Sponsor's protocol ID
- 14540
- Acronym
- UltraSjögren
- Status last verified
- Jun 2024
- First submitted
- 21 Mar 2024
- Last updated
- 26 Jun 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Inanc N, Jousse-Joulin S, Abacar K, Cimsit C, Cimsit C, D'Agostino MA, Naredo E, Hocevar A, Finzel S, Pineda C, Keen H, Iagnocco A, Hanova P, Schmidt WA, Mumcu G, Terslev L, Bruyn GA. The Novel OMERACT Ultrasound Scoring System for Salivary Gland Changes in Patients With Sjogren Syndrome Is Associated With MRI and Salivary Flow Rates. J Rheumatol. 2024 Mar 1;51(3):263-269. doi: 10.3899/jrheum.2023-0202.
PubMed 37914219Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, Rasmussen A, Scofield H, Vitali C, Bowman SJ, Mariette X; International Sjogren's Syndrome Criteria Working Group. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjogren's Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts. Arthritis Rheumatol. 2017 Jan;69(1):35-45. doi: 10.1002/art.39859. Epub 2016 Oct 26.
PubMed 27785888Brito-Zeron P, Baldini C, Bootsma H, Bowman SJ, Jonsson R, Mariette X, Sivils K, Theander E, Tzioufas A, Ramos-Casals M. Sjogren syndrome. Nat Rev Dis Primers. 2016 Jul 7;2:16047. doi: 10.1038/nrdp.2016.47.
PubMed 27383445Ferro F, Izzetti R, Vitali S, Aringhieri G, Fonzetti S, Donati V, Dini V, Mosca M, Gabriele M, Caramella D, Baldini C. Ultra-high frequency ultrasonography of labial glands is a highly sensitive tool for the diagnosis of Sjogren's syndrome: a preliminary study. Clin Exp Rheumatol. 2020 Jul-Aug;38 Suppl 126(4):210-215. Epub 2020 Oct 23.
PubMed 33095145Donati V, Ferro F, Governato G, Fulvio G, Izzetti R, Nardini V, Baldini C. Total area of inflammatory infiltrate and percentage of inflammatory infiltrate identify different clinical-serological subsets of primary Sjogren's syndrome better than traditional histopathological parameters. Clin Exp Rheumatol. 2020 Jul-Aug;38 Suppl 126(4):195-202. Epub 2020 Oct 23.
PubMed 33095147Izzetti R, Ferro F, Vitali S, Nisi M, Fonzetti S, Oranges T, Donati V, Caramella D, Baldini C, Gabriele M. Ultra-high frequency ultrasonography (UHFUS)-guided minor salivary gland biopsy: A promising procedure to optimize labial salivary gland biopsy in Sjogren's syndrome. J Oral Pathol Med. 2021 May;50(5):485-491. doi: 10.1111/jop.13162. Epub 2021 Feb 15.
PubMed 33501696Fulvio G, Donati V, Izzetti R, Fonzetti S, La Rocca G, Ferro F, Baldini C. Correspondence between minor salivary glands ultra-high frequency ultrasonography and histology: a case report of severe/atypical lymphoid infiltrate in Sjogren's syndrome. Clin Exp Rheumatol. 2022 Dec;40(12):2474-2475. doi: 10.55563/clinexprheumatol/rdbm3h. Epub 2022 Dec 20. No abstract available.
PubMed 36541238Fulvio G, Izzetti R, Aringhieri G, Donati V, Ferro F, Gabbriellini G, Mosca M, Baldini C. UHFUS: A Valuable Tool in Evaluating Exocrine Gland Abnormalities in Sjogren's Disease. Diagnostics (Basel). 2023 Aug 26;13(17):2771. doi: 10.3390/diagnostics13172771.
PubMed 37685309Izzetti R, Fulvio G, Nisi M, Gennai S, Graziani F. Reliability of OMERACT Scoring System in Ultra-High Frequency Ultrasonography of Minor Salivary Glands: Inter-Rater Agreement Study. J Imaging. 2022 Apr 15;8(4):111. doi: 10.3390/jimaging8040111.
PubMed 35448238
Study at a glance
From the registry record, last updated by the sponsor on 26 Jun 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ultra-High Frequency Ultrasonography (UHFUS) Evaluation of Salivary Glands in Patients With Suspected Sjögren's Syndrome
- ClinicalTrials.gov ID
- NCT06338735
- Acronym / sponsor ID
- UltraSjögren / 14540
- Conditions
- Sjogren's Syndrome
- Keywords
- ultra-high frequency ultrasonography, diagnostic imaging, Sjogren's syndrome, salivary glands
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 800 participants (estimated)
- Lead sponsor
- University of PisaUniversity, hospital or other
- Study start
- 11 Jan 2016 (actual)
- Primary completion
- 31 Dec 2026 (estimated)
- Study completion
- Dec 2030 (estimated)
- First posted
- 1 Apr 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Patients diagnosed with a diagnosis of Sjogren's syndrome performed according to the ACR/EULAR criteria will be included in the study. Sjogren's syndrome diagnosis will be performed following a complete diagnostic work-up involving rheumatologic assessment, glandular functional tests, and blood testing for anti-Ro(SSA) antibodies. Conventional ultrasonography of major salivary glands and ultra-high frequency ultrasonography (70 MHz) of minor salivary glands will be performed, and the scans assessed using the Outcome Measures in Rheumatology (OMERACT) scoring system (Score 0 normal glandular tissue, Score 1 mild glandular alteration, fine echogenicity or diffuse hypo-echogenicity, Score 2 moderate glandular alteration and focal hypoechoic areas with partial conservation of normal parenchyma, Score 3 diffuse presence of hypoechoic areas in the absence of normal glandular parenchyma with glandular fibrosis. Focus Score will be assessed following biopsy of minor salivary glands.
Detailed description
Primary Sjögren's syndrome is a complex autoimmune disease involving the exocrine salivary and lachrymal glands, with a progressive functional impairment caused by lymphocytic infiltration in the glandular tissue. The diagnosis is currently performed according to the criteria established in 2016 by the American College of Rheumatologists/European League Against Rheumatism (ACR/EULAR) and relies on 5 items, namely i) histologic Focus Score (FS) ≥1, ii) positivity to Anti-SSA (Ro) antibodies, iii) Ocular staining score ≥ 5 (or van Bijsterfeld score ≥ 4) on at least one eye, iv) Schirmer test ≤ 5 mm/5min on at least one eye and v) Unstimulated Salivary Flow Rate (USFR) ≤ 0.1 ml/min. Focus Score and positivity to antibodies are items with a weight of 3 points each, while the other items are assigned score 1. Diagnosis is performed with a total score ≥ 4 when summing the weights. While the improvement in the sensitivity of ACR/EULAR classification criteria by 5-10% has been previously reported for ultrasonography of major salivary glands, at present no evidence is available for minor salivary glands. Minor salivary glands ultrasonography with the use of ultra-high frequencies up to 70 MHz has been recently introduced in the diagnostic work-up of Sjögren's syndrome, and involves the assessment of glandular ultrasonographic structural alterations through the application of the Outcome Measures in Rheumatology (OMERACT) scoring system, which is routinely used for major salivary glands. The present study therefore aims to assess the correlation between minor salivary glands ultrasonography and ACR/EULAR items, in order to evaluate whether this technique may integrate the current evaluation of Sjögren's syndrome patients.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Sjogren's syndrome | Experimental | Other: Ultra-High Frequency Ultrasound scan of minor salivary glandspatients with Sjogren's syndrome diagnosed according to the ACR/EULAR criteria |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- adults ≥ 18 years of age
- clinical suspect of Sjogren\'s syndrome
- acceptance to undergo complete Sjogren\'s Syndrome diagnostic work-up
- acceptance to be included in the study.
Key exclusion criteria (3 listed)
- pregnancy or breastfeeding
- any acute or chronic condition that would limit the ability of the patient to participate in the study
- refusal to give informed consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ultra-High Frequency Ultrasound scan of minor salivary glandsPatients will undergo ultra-high frequency ultrasonography (70 MHz) of minor salivary glands, and the scans will be assessed using the OMERACT scoring system. Score 0 will be assigned in the presence of normal glandular tissue, Score 1 will correspond to mild glandular alteration, fine echogenicity or diffuse hypo-echogenicity, Score 2 will be assigned to moderate glandular alteration and focal hypoechoic areas with partial conservation of normal parenchyma, while in Score 3 diffuse presence of hypoechoic areas in the absence of normal glandular parenchyma with glandular fibrosis will be observed. | Other | Sjogren's syndrome |
Primary outcome
OMERACT score
Time frame: 1 month
Evaluation of ultrasonographic scans with the Outcome Measures in Rheumatology (OMERACT) scoring system, ranging between Score 0 (normal glandular tissue) and 3 (diffuse presence of hypoechoic areas in the absence of normal glandular parenchyma with glandular fibrosis )
Correspondence between ultrasonography and histology
Time frame: 1 month
Evaluation of the concordance between ultrasonographic score of minor salivary glands assessed with Outcome Measures in Rheumatology (OMERACT) scoring system (scores 0-3) and histology
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Jun 2024.
- Background: PubMed 37914219Inanc N, Jousse-Joulin S, Abacar K, Cimsit C, Cimsit C, D'Agostino MA, Naredo E, Hocevar A, Finzel S, Pineda C, Keen H, Iagnocco A, Hanova P, Schmidt WA, Mumcu G, Terslev L, Bruyn GA. The Novel OMERACT Ultrasound Scoring System for Salivary Gland Changes in Patients With Sjogren Syndrome Is Associated With MRI and Salivary Flow Rates. J Rheumatol. 2024 Mar 1;51(3):263-269. doi: 10.3899/jrheum.2023-0202.
- Background: PubMed 27785888Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, Rasmussen A, Scofield H, Vitali C, Bowman SJ, Mariette X; International Sjogren's Syndrome Criteria Working Group. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjogren's Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts. Arthritis Rheumatol. 2017 Jan;69(1):35-45. doi: 10.1002/art.39859. Epub 2016 Oct 26.
- Background: PubMed 27383445Brito-Zeron P, Baldini C, Bootsma H, Bowman SJ, Jonsson R, Mariette X, Sivils K, Theander E, Tzioufas A, Ramos-Casals M. Sjogren syndrome. Nat Rev Dis Primers. 2016 Jul 7;2:16047. doi: 10.1038/nrdp.2016.47.
- Results publication: PubMed 33095145Ferro F, Izzetti R, Vitali S, Aringhieri G, Fonzetti S, Donati V, Dini V, Mosca M, Gabriele M, Caramella D, Baldini C. Ultra-high frequency ultrasonography of labial glands is a highly sensitive tool for the diagnosis of Sjogren's syndrome: a preliminary study. Clin Exp Rheumatol. 2020 Jul-Aug;38 Suppl 126(4):210-215. Epub 2020 Oct 23.
- Results publication: PubMed 33095147Donati V, Ferro F, Governato G, Fulvio G, Izzetti R, Nardini V, Baldini C. Total area of inflammatory infiltrate and percentage of inflammatory infiltrate identify different clinical-serological subsets of primary Sjogren's syndrome better than traditional histopathological parameters. Clin Exp Rheumatol. 2020 Jul-Aug;38 Suppl 126(4):195-202. Epub 2020 Oct 23.
- Results publication: PubMed 33501696Izzetti R, Ferro F, Vitali S, Nisi M, Fonzetti S, Oranges T, Donati V, Caramella D, Baldini C, Gabriele M. Ultra-high frequency ultrasonography (UHFUS)-guided minor salivary gland biopsy: A promising procedure to optimize labial salivary gland biopsy in Sjogren's syndrome. J Oral Pathol Med. 2021 May;50(5):485-491. doi: 10.1111/jop.13162. Epub 2021 Feb 15.
- Results publication: PubMed 36541238Fulvio G, Donati V, Izzetti R, Fonzetti S, La Rocca G, Ferro F, Baldini C. Correspondence between minor salivary glands ultra-high frequency ultrasonography and histology: a case report of severe/atypical lymphoid infiltrate in Sjogren's syndrome. Clin Exp Rheumatol. 2022 Dec;40(12):2474-2475. doi: 10.55563/clinexprheumatol/rdbm3h. Epub 2022 Dec 20. No abstract available.
- Results publication: PubMed 37685309Fulvio G, Izzetti R, Aringhieri G, Donati V, Ferro F, Gabbriellini G, Mosca M, Baldini C. UHFUS: A Valuable Tool in Evaluating Exocrine Gland Abnormalities in Sjogren's Disease. Diagnostics (Basel). 2023 Aug 26;13(17):2771. doi: 10.3390/diagnostics13172771.
- Results publication: PubMed 35448238Izzetti R, Fulvio G, Nisi M, Gennai S, Graziani F. Reliability of OMERACT Scoring System in Ultra-High Frequency Ultrasonography of Minor Salivary Glands: Inter-Rater Agreement Study. J Imaging. 2022 Apr 15;8(4):111. doi: 10.3390/jimaging8040111.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Ultra-High Frequency Ultrasound scan of minor salivary glands in people with Sjogren's Syndrome, run by University of Pisa at 1 site in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 26 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Rossana Izzetti (+39050993037, rossana.izzetti@unipi.it), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
OMERACT score (time frame: 1 month). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06338735, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Jun 2024.