The validated patient-reported outcome for primary Sjogren's disease. Three questions covering dryness (average of ocular and oral), fatigue, and pain - each rated 0 to 10. The final ESSPRI score is the simple average of these three domains. Acceptable symptom state is defined as ESSPRI below 5. Minimal clinically important improvement is 1 point or 15%.
The dryness domain is the average of ocular and oral dryness scores. Rate each 0 (not severe) to 10 (maximally severe). These questions refer to the past week.
| ESSPRI | Status | Clinical Meaning |
|---|---|---|
| < 5 | Acceptable Symptom State | Patient-acceptable symptom state (PASS). Well-tolerated symptom burden. |
| 5 to 6.9 | Moderate Burden | Significant symptom burden. May warrant targeted symptomatic therapy review. |
| 7+ | High Symptom Burden | High patient-reported symptom severity. Prioritize symptom management alongside systemic therapy. |
MCID: decrease of at least 1 point or 15% from baseline. PASS: score below 5. These were defined in the validation cohort of 790 patients (Seror et al., Ann Rheum Dis 2014).
Important: ESSPRI and ESSDAI assess different dimensions of Sjogren's disease. Correlations between them are typically weak (r = 0.07 to 0.29). A patient may have well-controlled ESSDAI (systemic activity) but high ESSPRI (symptom burden), or vice versa. Both should be assessed at every visit.
ESSPRI was developed by the EULAR Sjogren's Task Force and published by Seror and colleagues in Annals of the Rheumatic Diseases in 2011. The instrument was derived using consensus methods with a worldwide panel of primary Sjogren's experts. Validation in 790 patients across two prospective cohorts confirmed the PASS threshold of less than 5 and the MCID of 1 point or 15% (Seror et al., 2014). ESSPRI is now the standard patient-reported endpoint in Sjogren's clinical trials, alongside ESSDAI.