History of nontuberculous mycobacteria infection linked to incident Sjögren’s syndrome

MADRID — Recent diagnosis with Sjögren’s syndrome appears to be significantly linked to a history of nontuberculous mycobacteria infection, according to findings presented at the EULAR Annual Congress.

However, no such association has been found between Sjögren’s syndrome (SS) and history of tuberculosis, the researchers reported.

“Although the exact disease mechanism behind [Sjögren’s syndrome] remains elusive, a variety of environmental, genetic and hormonal factors have been linked with the development and different manifestations of this debilitating disease,” presenter Hsin-Hua Chen, MD, PhD, of the Taichung Veterans General Hospital, Taiwan, Province of China, said in a press release. “Identifying [nontuberculous mycobacteria] NTM as one of the triggers will hopefully provide a clue to the future development of a targeted therapy for these patients.”

Using nationwide population-based claims data, researchers evaluated 5,751 newly diagnosed cases of SS (mean ± SD age, 54 ± 14 years; 87.8% were female), as well as 86,265 non-SS controls (mean ± SD age, 54 ± 14 years; 87.8% were female) matched at a 1:15 ratio for age, gender and year of initial diagnosis date. Diagnosis of NTM was determined through ICD9-CM disease codes, as well as the use of NTM-associated antibacterial medication.

Researchers found a correlation between history of NTM infection (odds ratio [OR] =11.24) and incident SS, but not between history of TB infection and incident SS (OR = 1.29) after adjustment for Charlson comorbidity index and bronchiectasis. Patients between the ages of 45 years and 65 years had the greatest extent of association between NTM and SS risk (OR = 39.24).

Researchers noted the possibility that SS onset may, in some cases, have preceded the NTM infection could not be conclusively ruled out. Of seven subjects with NTM history later diagnosed with SS, three of these patients were diagnosed within 3 months of NTM infection, suggesting the possibility of coexisting disease. However, the remaining four patients were diagnosed an average of 2.9 years after NTM infection.

The strong correlation between the two diseases warrants keeping both conditions in mind when a patient presents with one.
“The significant association between NTM infection and newly diagnosed [Sjögren’s syndrome] demonstrated in our study certainly supports the need to screen for the presence of [Sjögren’s syndrome] in any patient previously infected with NTM to enable prompt diagnosis and treatment,” Chen said in the release. – by Jennifer Byrne

References:

Chen HH, et al. Abstract# OP0074. Presented at: EULAR Annual Congress; June 14-17, 2017; Madrid.

www.congress.eular.org/press_press_releases.cfm

Disclosure: Chen reports no relevant disclosures.