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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