AB0318 PREVALENCE OF SECONDARY SJOGREN'S SYNDROME IN PATIENTS WITH RHEUMATOID ARTHRITIS- A SINGLE CENTER STUDY FROM NORTHERN INDIA

Abstract

Background: Sjogren's syndrome (SS) is a systemic autoimmune disease characterized by lymphocytic infltration of salivary and lacrimal glands leading to dry eyes and dry mouth. Sjogren's syndrome either present alone (primary Sjogren's syndrome) or sometimes can occur with other autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus, and scleroderma. In such instances, the condition is termed secondary Sjogren's syndrome. SS may be a marker of more aggressive joint disease in patients with RA, and hence it is essential to characterize the symptoms in the RA cohort, which may help in the management and treatment of the disease. Objectives: Primary Objective The primary objective of the current study is to estimate the prevalence of secondary Sjogren's syndrome in a cohort of patients with rheumatoid arthritis. Secondary Objective To compare the clinical characteristics in rheumatoid arthritis patients with Sjogren's syndrome and in rheumatoid arthritis patients without Sjogren's syndrome. Methods: The study was conducted from 2016-2018 in a tertiary care hospital in the Department of Rheumatology, New Delhi, India. Patients with a rheu-matologist-diagnosed RA were enrolled. There were 726 patients with rheumatoid arthritis. Patients were enquired about their symptoms. Out of 726, 193 had secondary Sjogren's syndrome (26.58%). In patients without Sjogren's syndrome, complete clinical data were available only for 377 patients hence the analysis on the comparison of clinical characteristics was limited to 377 patients. The other patients were excluded due to lack of the data required for the study. Results: It was identifed that out of 726 patients, 193 had symptoms of secondary Sjogren's like dry eyes dry mouth, or both. It was found that in patients with secondary Sjogren's syndrome (n=193), the mean age was signifcantly higher than those patients without secondary Sjogren's syndrome (n=377) [52.58 ± 12.36 Vs. 48.42 ± 13.98, p=0.0005]. Similarly, the mean disease duration was signifcantly higher among RA patients with secondary SS than those without SS [10.76 ± 8.34 Vs. 6.81 ± 7.29, p<0.0001]. Similarly, co-morbidities like hypertension, diabetes mellitus, and hypothyroidism were more seen in patients with rheumatoid arthritis with Sjogren's syndrome. In a meta-analysis involving 18 studies1, it was identifed that the prevalence of SS in RA was 19.5%. The differences in the prevalence of secondary SS in RA patients could be attributable to inter-ethnic variation, disease duration, and clinical scores employed in the studies. Similar to our study, Santhosh et al.2 reported that patients with secondary SS had a longer disease duration than those without secondary SS. Conclusion: The prevalence of Sjogren's syndrome among patients with rheumatoid arthritis in the North Indian cohort of patients with RA was 26.58%.