Overlapping Sjögren’s syndrome linked to lower odds of RA remission
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An overlapping case of Sjögren’s syndrome can lower the likelihood of achieving remission or low disease activity among patients with rheumatoid arthritis, according to data published in Arthritis Research & Therapy.
“A growing number of cross-sectional studies have shown that RA-SS patients tend to have more severe arthritis and visceral involvement than those without (RA-noSS),” Huijuan Zhang, MD, of the Peking University First Hospital, in Beijing, China, and colleagues wrote. “Could the worse arthritis be attributed to a continuous poor therapeutic response? Will strengthening the management of overlapping SS reverse the poor outcome? The data regarding the impact of overlapping SS on RA therapeutic response, to our best knowledge, are scarce.”
To analyze the impact of overlapping Sjögren's syndrome on therapeutic response in RA, in a real-world cohort, Zhang and colleagues studied the medical records of 1,099 patients with RA at a tertiary university hospital, from 2009 to 2019. The researchers collected participants’ composite disease activity scores at each follow-up point, and compared the therapeutic response between RA patients with overlapping Sjögren's syndrome and those without.
To correct for confounders that may impact the therapeutic response, the researchers analyzed both propensity score matched and unmatched cohorts, using the Cox proportional hazards model. Among the participants, 129 demonstrated overlapping Sjögren's syndrome, confirmed using anti-SSA or a minor salivary gland biopsy. After propensity score matching based on their baseline characteristics, Zhang and colleagues statistically extracted 126 of the 129 participants with overlapping Sjögren’s syndrome, and 126 of those without.
According to the researchers, overlapping Sjögren’s syndrome was associated with a 29%, 26%, 18% and 22% lower likelihood of achieving RA remission, as defined by Disease Activity Score 28-joint count-erythrocyte sedimentation rate (DAS28-ESR), DAS28-C reactive protein (CRP), the Simple Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI), respectively. Odds of reaching low disease activity were similarly reduced. Although ESR was most significantly impacted metric (HR = 0.69; 95% CI, 0.61-0.79), other measures RA disease activity were also impacted.
“Overlapping SS reduced the probability of reaching RA remission/LDA by approximately 20% to 30%,” Zhang and colleagues wrote. “Based on the shared mechanisms and observational findings, overlapping SS should be considered as one of the poor prognostic factors of RA. Exploring the effect of overlapping SS on the radiographic outcomes in RA patients is deserved.” – by Jason Laday
Disclosures: The researchers report no relevant financial disclosures.
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