Increased risk of acute pancreatitis in patients with sjögren syndrome: A nationwide population-based cohort study

Abstract

Background: Sjögren's syndrome (SS) is a chronic autoimmune disease with lymphocytic exocrine gland infiltration causing dry mouth and eyes. The disease can develop alone (primary SS, PSS) or with other autoimmune diseases (secondary SS, SSS). PSS has been suggested to increase the acute pancreatitis risk. However, whether all patients with SS share this higher risk remains uncertain. This nationwide population-based cohort study aimed to detect associations between SS and acute pancreatitis. Methods: We identified 11,922 individuals with SS cohort and 47,688 individuals without SS (non-SS cohort) between 2000 and 2010 from the Taiwan National Health Insurance database. We matched the individuals between the SS and non-SS cohorts according to age, gender, and index year at a 1:4 ratio. We used a Cox multivariable proportional-hazards model to determine the effects of SS on the acute pancreatitis risk. Results: The SS cohort had a higher acute pancreatitis risk than the non-SS cohort after covariate adjustments (adjusted hazard ratio [HR], 3.374; 95% confidence interval [CI], 2.869-3.969). Patients with PSS exhibited a 2.872-fold risk (95% CI, 2.611-3.901) and patients with SSS a 4.121-fold risk (95% CI, 3.752-5.124) for acute pancreatitis. Our subgroup analyses revealed that patients with SS and systemic lupus erythematosus (adjusted HR, 3.85; 95% CI, 3.259-4.999), rheumatoid arthritis (adjusted HR, 4.298; 95% CI, 3.862-5.286), systemic sclerosis (adjusted HR, 2.765; 95% CI, 2.26-3.68), or polymyositis (adjusted HR, 2.641; 95% CI,1.847-3.101) and dermatomyositis (adjusted HR, 3.77; 95% CI, 2.894-4.502) had higher acute pancreatitis risk. Conclusions: Patients with SS presented increased acute pancreatitis risks than patients without SS, and patients with SSS had higher acute pancreatitis risks than patients with PSS. Physicians should be aware of this increased risk in patients with SS.