Sjögren Syndrome Adds to RA Treatment Challenges
Compared with patients with both rheumatoid arthritis (RA) and Sjögren, patients with RA only had greater improvements in RA disease activity and patient-reported outcomes after initiating biologic or targeted synthetic disease-modifying antirheumatic drug (DMARD) therapy, according to a study published online in the journal Rheumatology International.
“Physicians may wish to consider Sjögren syndrome status when managing patients with RA,” the researchers wrote. “Specifically, patients with RA and Sjögren syndrome may require closer monitoring and more aggressive intervention to improve their disease experience than patients with RA only.”
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The study included 283 pairs of matched adults with RA, with and without Sjögren syndrome, from the Consortium of Rheumatology Researchers of North America RA registry. All participants initiated a biologic or targeted synthetic DMARD as part of standard care.
After 12 months of follow-up, the average change in Clinical Disease Activity Index (CDAI) score was 8.8 points in patients with RA and Sjögren syndrome compared with 9.3 points in patients with RA only. According to researchers, the numerically lower change in CDAI score suggested greater impairment in patients with RA and Sjögren syndrome.
Meanwhile, reductions in patient-reported pain, fatigue, and morning stiffness were 2 to 3 times lower in patients with RA and Sjögren syndrome, again suggesting greater impairment, compared with patients with RA only, according to the study.
“More aggressive treatment of Sjögren syndrome with RA may be needed,” researchers advised.
—Jolynn Tumolo
Reference
Harrold LR, Shan Y, Rebello S, et al. Disease activity and patient-reported outcomes in patients with rheumatoid arthritis and Sjögren's syndrome enrolled in a large observational US registry [published online ahead of print May 24, 2020 May 24]. Rheumatol Int. doi:10.1007/s00296-020-04602-8
