Background Patients with rheumatoid arthritis (RA) can develop sicca symptoms which may be related to secondary Sjögren's syndrome (sSS).
Objectives To assess the prevalence and clinical characteristics of sSS in RA patients.
Methods In this cross-sectional study, 96 consecutive established RA patients referred to our outpatient clinic were submitted to a complete diagnostic work-up for the presence of sSS according to the American-European Consensus Group criteria. Patients underwent clinical examination including DAS-28 score, Schirmer's test and sialometry of submandibular/sublingual (SM/SL) glands and parotid (PAR) glands. In addition, patients were asked to complete the Health Assessment Questionnaire (HAQ), RAND-36 and Multidimensional Fatigue Inventory (MFI). Clinical characteristics were compared between RA patients fulfilling the criteria for sSS, RA patients with at least one sicca symptom of the eyes or mouth but no sSS and RA patients without sicca symptoms.
Results Of the 96 included RA patients, 75 (78%) were female, mean age was 54±10 years and median disease duration of RA was 10 years (IQR 5–17). In total, 38 patients (39.6%) reported to have at least one sicca symptom of the eyes or mouth. Six patients (6.3%) were diagnosed with sSS. RA patients with sSS had higher disease activity, lower tears production and lower salivary flow rates compared to patients with and without sicca symptoms. Patients with sicca symptoms used more often xerogenic drugs, had higher disease activity and lower salivary flow rates than patients without sicca symptoms. No differences were found in the proportion of patients that were anti-SSA/SSB antibody positive between the groups. Furthermore, both patients with sSS and patients with sicca symptoms experienced worse physical functioning, lower health-related quality of life and more fatigue than RA patients without sicca symptoms (Table 1).
Conclusions The prevalence of sicca symptoms and sSS was 39.6% and 6.3%, respectively, in our study group of established RA patients in daily clinical practice. Both the presence of sicca symptoms and sSS was associated with higher disease activity, impaired health-related quality of life and fatigue in RA patients.
Vitali et al. Ann Rheum Dis. 2002;61(6):554–8.
Disclosure of Interest None declared