Associations between Sjögren Syndrome, Sociodemographic Factors, Comorbid Conditions, and Scleritis in a Taiwanese Population-Based Study

This nationwide, population-based, retrospective, matched case–control study included 111,960 newly diagnosed patients with scleritis who were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification code 379.0, selected from the Taiwan National Health Insurance Research Database. Demographic characteristics, Sjögren syndrome, and comorbid conditions within 1 year before the scleritis diagnosis were examined using univariate logistic regression analyses, and a paired t-test was used for continuous variables. Adjusted logistic regression was used to compare the prognosis odds ratio (OR) of the patients with scleritis with the controls. After adjustment for confounders, patients with Sjögren syndrome were remarkably more likely to have scleritis than the controls (OR = 33.53, 95% confidence interval (CI) = 27.43–40.97, p < 0.001). Other conditions found to have increased odds of scleritis included post ocular pterygium, glaucoma, and scleral surgery (OR = 4.01, 95% CI = 3.64–4.43; OR = 3.16, 95% CI = 2.24–4.47; OR = 6.83, 95% CI = 5.34–8.74, respectively); systemic infections, such as syphilis, tuberculosis, and a human herpes viral infection (OR = 4.01, 95% CI = 2.93–5.50; OR = 2.24, 95% CI = 1.94–2.58; OR = 8.54, 95% CI = 8.07–9.03, respectively); and systemic diseases, such as rheumatoid arthritis, granulomatous vasculitis, systemic lupus erythematosus, ankylosing spondylitis, and gout (OR = 2.93, 95% CI = 2.66–3.23; OR = 7.37, 95% CI = 3.91–13.88; OR = 3.18, 95% CI = 2.63–3.85; OR = 5.57, 95% CI = 4.99–6.22; OR = 2.84, 95% CI = 2.72–2.96, respectively). The results strongly support an association between Sjögren syndrome, post ocular surgery, systemic infection disease, systemic autoimmune disease, and scleritis.

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Neuropsychiatric syndromes in patients with systemic lupus erythematosus and primary Sjogren syndrome: a comparative population-based study

Annals of the Rheumatic Diseases ◽

10.1136/ard.2008.098301 ◽

2008 ◽

Vol 68 (10) ◽

pp. 1541-1546 ◽

Cited By ~ 74

Author(s):

E Harboe ◽

A B Tjensvoll ◽

S Maroni ◽

L G Goransson ◽

O J Greve ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Population Based ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Systemic Lupus ◽

Population Based Study ◽

Primary Sjögren Syndrome ◽

Comparative Population

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Bidirectional Relationship Between Primary Sjögren Syndrome and Non-Hodgkin Lymphoma: A Nationwide Taiwanese Population-based Study

The Journal of Rheumatology ◽

10.3899/jrheum.191027 ◽

2020 ◽

Vol 47 (9) ◽

pp. 1374-1378

Author(s):

Li-Hui Wang ◽

Wei-Ming Wang ◽

Chun-Yu Lin ◽

Sheng-Hsiang Lin ◽

Chi-Chang Shieh

Keyword(s):

Hodgkin Lymphoma ◽

Population Based ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Research Database ◽

Population Based Study ◽

Non Hodgkin Lymphoma ◽

Primary Sjögren Syndrome ◽

Bidirectional Relationship ◽

New Onset

Objective.Bidirectional relationships between some autoimmune diseases and non-Hodgkin lymphoma (NHL) may exist. We conducted this nationwide population-based study in Taiwan to investigate whether there is a bidirectional relationship between primary Sjögren syndrome (pSS) and NHL.Methods.Using the National Health Insurance Research Database of Taiwan, we identified 15,636 patients with new-onset pSS without previous cancer and 25,074 patients with new-onset NHL without previous pSS as 2 non-overlapping cohorts from 1998 to 2012, and followed them until 2013. Standardized incidence ratios (SIR) for NHL in the patients with pSS and SIR for pSS in the patients with NHL were compared with the general population.Results.Among the 15,636 patients with pSS, 741 developed cancers, including 51 with NHL. The highest SIR of specific cancer risk in patients with pSS was that for NHL (SIR 4.6, 95% CI 3.4–6.0). Among the 25,074 patients with NHL, 49 developed pSS; the SIR was also increased (SIR 3.2, 95% CI 2.4–4.2). The risk was highest within 1 year after the diagnosis of each disease.Conclusion.This nationwide population-based study is the first to report a bidirectional relationship between pSS and NHL. Our findings suggest being alert for patients with pSS or NHL who have early signs of the other disease in clinical care. The underlying mechanisms of the bidirectional relationship merit further investigation.

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Prognostic markers of lymphoma development in primary Sjögren syndrome

Lupus ◽

10.1177/0961203319857132 ◽

2019 ◽

Vol 28 (8) ◽

pp. 923-936 ◽

Cited By ~ 16

Author(s):

S Retamozo ◽

P Brito-Zerón ◽

M Ramos-Casals

Keyword(s):

Risk Factors ◽

Lupus Erythematosus ◽

Activity Index ◽

Sjögren Syndrome ◽

Systemic Autoimmune Disease ◽

Low Grade ◽

Sjogren Syndrome ◽

Close Link ◽

Systemic Involvement ◽

Primary Sjögren Syndrome

Sjögren syndrome is a systemic autoimmune disease that principally affects women between the fourth and sixth decades of life who present with sicca symptomatology caused by dryness of the main mucosal surfaces. The clinical spectrum of Sjögren syndrome extends from dryness to systemic involvement. Since 1978, Sjögren syndrome has been closely associated with an enhanced risk of lymphoma, one of the most severe complications a patient may develop. Primary Sjögren syndrome patients have a 10–44-fold greater risk of lymphoma than healthy individuals, higher than that reported for systemic lupus erythematosus and rheumatoid arthritis. The close link between lymphoma and Sjögren syndrome is clearly exemplified by the very specific type of lymphoma arising in Sjögren syndrome patients, mainly low-grade B-cell lymphomas (predominantly a marginal zone histological type) with primary extranodal involvement of the major salivary glands (overwhelmingly parotid), with a primordial role of cryoglobulinemic-related markers (both clinical and immunological). The most recent studies support a higher number of risk factors detected in an individual leads to a higher lymphoma risk. A close follow-up of high-risk groups with longitudinal assessments of all known risk factors, including cryoglobulin-related markers and EULAR Sjögren's syndrome disease activity index measurement in particular, is mandatory.

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Epiglottitis in Patients With Preexisting Autoimmune Diseases: A Nationwide Case–Control Study in Taiwan

Ear Nose & Throat Journal ◽

10.1177/01455613211033689 ◽

2021 ◽

pp. 014556132110336

Author(s):

Cheng-Ming Hsu ◽

Ming-Shao Tsai ◽

Yao-Hsu Yang ◽

Ko-Ming Lin ◽

Yun-Ting Wang ◽

...

Keyword(s):

Autoimmune Diseases ◽

Population Based ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Research Database ◽

The Novel ◽

Population Database ◽

Acute Epiglottitis ◽

Increased Risk ◽

Taiwan National Health Insurance

Objectives: The role of autoimmune diseases on the risk for acute epiglottitis remains uncertain. This study aimed to delineate the association between epiglottitis and autoimmune diseases using population database. Methods: A population-based retrospective study was conducted to analyze claims data from Taiwan National Health Insurance Research Database collected over January, 2000, to December, 2013. Results: In total, 2339 patients with epiglottitis were matched with 9356 controls without epiglottitis by sex, age, socioeconomic status, and urbanization level. The correlation between autoimmune diseases and epiglottitis was analyzed by multivariate logistic regression. Compared with controls, patients with epiglottitis were much more likely to have preexisting Sjögren syndrome (adjusted odds ratio [aOR]: 2.37; 95% CI: 1.14-4.91; P = .021). In addition, polyautoimmunity was associated with increased risk of epiglottitis (aOR: 2.08; 95% CI: 1.14-3.80; P = .018), particularly in those aged >50 years (aOR: 2.61; 95% CI: 1.21-5.66; P = .015). Conclusions: Among autoimmune diseases, we verify the association between epiglottitis and Sjögren syndrome in Taiwan. Furthermore, we present the novel discovery that patients with epiglottitis have an increased risk of polyautoimmunity, particularly those aged >50 years.

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Faculty Opinions recommendation of The co-occurrence of endometriosis with multiple sclerosis, systemic lupus erythematosus and Sjogren syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.9768956.10593056 ◽

2011 ◽

Author(s):

Ricardo Buquet ◽

Edgardo Rolla

Keyword(s):

Multiple Sclerosis ◽

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Systemic Lupus

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Primary Sjogren syndrome increases the risk of bisphosphonate-related osteonecrosis of the jaw

Scientific Reports ◽

10.1038/s41598-020-80622-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Pei-I Kuo ◽

Tzu-Min Lin ◽

Yu-Sheng Chang ◽

Tsung-Yun Hou ◽

Hui-Ching Hsu ◽

...

Keyword(s):

Propensity Score ◽

Osteonecrosis Of The Jaw ◽

Sjögren Syndrome ◽

Cox Proportional Hazards Model ◽

Matched Pair ◽

Sjogren Syndrome ◽

Research Database ◽

Primary Sjögren Syndrome ◽

Defined Daily Doses ◽

Increased Risk

AbstractThe risk of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in primary Sjogren syndrome (pSS) has rarely been explored. To explore the association between BRONJ and pSS, we conducted a population-based propensity-score-matched cohort study using Taiwan’s National Health Insurance Research Database, including pSS patients receiving antiosteoporotic therapy and patients without pSS receiving antiosteoporotic therapy. A 1:4 matched-pair cohort based on propensity score was created. The stratified Cox proportional hazards model compared the risk of BRONJ in the pSS and non-pSS groups. In the study, 23,280 pSS patients and 28,712,152 controls were enrolled. After matching, 348 patients with pSS receiving antiosteoporotic drugs and 50,145 without pSS receiving antiosteoporotic drugs were included for analysis. The risk of developing BRONJ was 1.96 times higher in pSS patients compared with non-pSS patients after adjustment for age, sex, and comorbidities. No dose–response effect was observed in the bisphosphonate-treated pSS cohorts, documented as the cumulative defined daily doses of either < 224 or ≥ 224 (hazard ratio [HR]: 2.407, 95% confidence interval [CI] 1.412–7.790; HR: 2.143, 95% CI 1.046–4.393, respectively) increased risk of developing osteonecrosis of the jaw. In conclusion, the risk of BRONJ is significantly higher in patients with pSS compared with the general population.

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