Título:
Mortality risk factors in primary Sjögren syndrome: a real-world, retrospective, cohort study
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Autor:
Brito-Zerón, Pilar
Flores-Chávez, Alejandra
Horváth, Ildiko Fanny
Rasmussen, Astrid
Xiaomei, Li
Olsson, Peter
Vissink, Arjan J.
Priori, Roberta
Armaǧan, Berkan
Hernández-Molina, Gabriela
Consani, Sandra
Flores-Chávez, Alejandra
Horváth, Ildiko Fanny
Rasmussen, Astrid
Xiaomei, Li
Olsson, Peter
Vissink, Arjan J.
Priori, Roberta
Armaǧan, Berkan
Hernández-Molina, Gabriela
Consani, Sandra
Tutor:
Tipo de documento:
Artículo
Editor:
Palabras clave:
Cardiovascular
Infection
Lymphoma
Mortality
Sjögren syndrome
Systemic disease
Infection
Lymphoma
Mortality
Sjögren syndrome
Systemic disease
Descriptores:
SÍNDROME DE SJÖGREN
METABOLISMO BASAL
MORTALIDAD
LINFOMA
INFECCIONES
METABOLISMO BASAL
MORTALIDAD
LINFOMA
INFECCIONES
Año de publicación:
2023
Contenido:
Resumen:
Background
What baseline predictors would be involved in mortality in people with primary Sjögren syndrome (SjS) remains uncertain. This study aimed to investigate the baseline characteristics collected at the time of diagnosis of SjS associated with mortality and to identify mortality risk factors for all-cause death and deaths related to systemic SjS activity measured by the ESSDAI score.
Methods
In this international, real-world, retrospective, cohort study, we retrospectively collected data from 27 countries on mortality and causes of death from the Big Data Sjögren Registry. Inclusion criteria consisted of fulfilling 2002/2016 SjS classification criteria, and exclusion criteria included chronic HCV/HIV infections and associated systemic autoimmune diseases. A statistical approach based on a directed acyclic graph was used, with all-cause and Sjögren-related mortality as primary endpoints. The key determinants that defined the disease phenotype at diagnosis (glandular, systemic, and immunological) were analysed as independent variables.
Findings
Between January 1st, 2014 and December 31, 2023, data from 11,372 patients with primary SjS (93.5% women, 78.4% classified as White, mean age at diagnosis of 51.1 years) included in the Registry were analysed. 876 (7.7%) deaths were recorded after a mean follow-up of 8.6 years (SD 7.12). Univariate analysis of prognostic factors for all-cause death identified eight Sjögren-related variables (ocular and oral tests, salivary biopsy, ESSDAI, ANA, anti-Ro, anti-La, and cryoglobulins). The multivariate CPH model adjusted for these variables and the epidemiological features showed that DAS-ESSDAI (high vs no high: HR = 1.68; 95% CI, 1.27–2.22) and cryoglobulins (positive vs negative: HR = 1.72; 95% CI, 1.22–2.42) were independent predictors of all-cause death. Of the 640 deaths with available information detailing the specific cause of death, 14% were due to systemic SjS. Univariate analysis of prognostic factors for Sjögren-cause death identified five Sjögren-related variables (oral tests, clinESSDAI, DAS-ESSDAI, ANA, and cryoglobulins). The multivariate competing risks CPH model adjusted for these variables and the epidemiological features showed that oral tests (abnormal vs normal results: HR = 1.38; 95% CI, 1.01–1.87), DAS-ESSDAI (high vs no high: HR = 1.55; 95% CI, 1.22–1.96) and cryoglobulins (positive vs negative: HR = 1.52; 95% CI, 1.16–2) were independent predictors of SjS-related death.
Interpretation
The key mortality risk factors at the time of SjS diagnosis were positive cryoglobulins and a high systemic activity scored using the ESSDAI, conferring a 2-times increased risk of all-cause and SjS-related death. ESSDAI measurement and cryoglobulin testing should be considered mandatory when an individual is diagnosed with SjS.
Descripción:
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Editorial:
Elsevier
EN:
eClinicalMedicine. 2023;61
Financiadores:
Citación:
Brito-Zerón P, Flores-Chávez A, Horváth I y otros. Mortality risk factors in primary Sjögren syndrome: a real-world, retrospective, cohort study. eClinicalMedicine [en línea]. 2023;61. 16 p.
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ISSN:
2589-5370
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Licencia:
Licencia Creative Commons Atribución - No Comercial - Sin Derivadas (CC - By-NC-ND 4.0)
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| Ficheros | Descripción | Tamaño | Formato | ||
|---|---|---|---|---|---|
| Mortality risk factors in primary Sjögren syndrome.pdf | Mortality risk factors in primary Sjögren syndrome | 6.3 MB | Adobe PDF |