J Korean Med Sci.  2020 Nov;35(45):e369. 10.3346/jkms.2020.35.e369.

The Prevalence of Sjögren's Syndrome in Rheumatoid Arthritis Patients and Their Clinical Features

• Kim H
• Cho SK
• Kim HW
• Han J
• Kim Y
• Hwang KG
• Sung YK

• KMID: 2508800
• DOI: http://doi.org/10.3346/jkms.2020.35.e369

Abstract

Background
To estimate the prevalence of Sjögren's syndrome (SS) in patients with rheumatoid arthritis (RA) and to compare the clinical features of RA patients with and without SS.
Methods
We conducted a retrospective study of RA patients who visited a rheumatology clinic in a tertiary referral hospital in Korea between May 20 and July 22, 2016. All patients fulfilled the classification criteria for RA, and the diagnosis of SS was made clinically by rheumatologists and according to the 2002 American-European Consensus Group (AECG), 2012 American College of Rheumatology (ACR), and 2016 ACR/European League Against Rheumatism (EULAR) classification criteria. The prevalence was estimated as the number of SS patients within the total number of RA patients. The disease activity and treatment pattern of RA were compared between patients with and without SS.
Results
Among 827 RA patients, 72 patients (8.7%) were diagnosed with SS by a rheumatologist, though only 60 patients (7.3%) satisfied the 2002 AECG classification criteria for SS. Fifty-two patients (6.3%) and 56 patients (6.8%) fulfilled the 2012 ACR and 2016 ACR/EULAR classification criteria, respectively. The prevalence of SS in RA patients was 10.5%, 17.0%, and 67.6% in rheumatoid factor, antinuclear antibody (≥ 1:80), and anti-Ro antibody positive patients, respectively.
Conclusion
The prevalence of SS among RA patients was 8.7% according to rheumatologists' diagnosis. The presence of SS did not affect the treatment patterns of RA patients. However, the autoantibody profiles and demographics of RA patients with SS differed from those of patients without SS.

Keyword

Epidemiology; Prevalence; Sjögren's Syndrome; Rheumatoid Arthritis

Figure

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  Fig. 1 Patient selection flow for patients with RA and coexisting SS.RA = rheumatoid arthritis, SS = Sjögren's syndrome, ACR = American College of Rheumatology, EULAR = European League Against Rheumatism.

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  Fig. 2 Prevalence of Sjögren's syndrome in RA patients, overall and with sicca symptoms.RA = rheumatoid arthritis, AECG = American-European Consensus Group, ACR = American College of Rheumatology, EULAR = European League Against Rheumatism.

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  Fig. 3 Prevalence of Sjögren's syndrome in RA patients positive for specific autoantibodies.RA = rheumatoid arthritis, AECG = American-European Consensus Group, ACR = American College of Rheumatology, EULAR = European League Against Rheumatism, RF = rheumatoid factor, ANA = anti-nuclear antibody.

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