129 it was possible to compare the course of SFN-related complaints with the reduction of inflammation during treatment with infliximab in a well-defined cohort of patients with sarcoidosis. Methods All sarcoidosis patients treated with infliximab at the St. Antonius Hospital between January 2010 – Oct 2021 were screened for inclusion. All patients signed informed consent (via Biobank informed consent, R05-08A). Sarcoidosis is diagnosed based on the criteria of the American Thoracic Society/European Respiratory Society.15 From these patients, start and stop dates of infliximab treatment were noted. The maximal Standardized Uptake Value (SUVmax) from FDG-PET was used to define sarcoidosis activity. The Small Fiber Neuropathy Screening List (SFNSL) was used to identify the amount and changes in SFN related symptoms during treatment. The complete SFNSL questionnaire consists of 21 questions, with a score per question ranging between 0 for no complaints and 4 for maximal complaints. The SFNSL was correlated with temperature threshold testing (TTT) in an important reference paper by Hoitsma et al.16 According to this paper, an SFNSL score below 11 suggest the absence of SFN based on the fact that no abnormal TTT was found in those patients. A score above 48 suggests the presence of SFN based on the fact that all patients with a score above 48 had an abnormal TTT. Eighty percent of the sarcoidosis patients with an SFNSL score between 11-48, showed an abnormal TTT suggesting presence of SFN. Furthermore, according to the SFNSL validation study, it is very likely for the group with a score between 11-48 to develop SFN within 2 years. Inclusion criteria: Sarcoidosis with infliximab treatment for at least 3 months At least two SFNSL scores with at least 3 months in between Two or more SFNSL-scores within one treatment period SFNSL score up to 14 days around start date of treatment SUVmax data available 90 days before or 14 days after treatment initiation SFNSL-score ≥ 11 Exclusion criteria: No infliximab treatment Only one SFNSL-score within a treatment period SFNSL-score at start < 11 PET-scan date difference of >90 days with SFNSL-score date SFNSL questionnaires during treatment periods were collected. In case of multiple treatment periods, the longest period is used. In order to examine the effects of infliximab on SFN related symptoms, the SFNSL-score within 14 days around start and the most recent score were selected. The minimal important difference with clinical relevance on the SFNSL-score, is set on 3.5 points.17 SUVmax was collected in order to investigate the response of sarcoidosis activity on infliximab treatment. Only values from the longest treatment period were included, within 90 days before or 14 days after initiation and the most recent from that period. Moreover, SUVmax had to be available 90 days around the most recent SFNSL-score. Statistical analysis was performed with IBM SPSS 26.0 Statistics software. Since data was not normally distributed, the Wilcoxon signed rank test was used to calculate significance of difference between the first and last scores. 8 135 8
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