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Comorbidities in the UK Primary Sjögren’s Syndrome Registry

Lookup NU author(s): Dr Jessica Tarn, Dr Dennis LendremORCiD, Professor Michael Barnes, John CasementORCiD, Professor Fai NgORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Copyright © 2022 Tarn, Lendrem, Barnes, Casement and Ng. Introduction: Primary Sjögren’s Syndrome (PSS) is a chronic disease characterised by symptoms of oral and ocular dryness, pain, fatigue, anxiety and depression. PSS patients can be subclassified by the pattern of severity of these five key symptoms using the Newcastle Sjögren’s Stratification Tool (NSST). Although PSS is often associated with one or more comorbidities, the relationship between comorbidities, polypharmacy, and PSS symptom burden is unclear. Using data from the UK Primary Sjögren’s Syndrome Registry (UKPSSR) we describe the landscape of polypharmacy and comorbidities in PSS. Methods: The UKPSSR is research biobank of clinically well-defined PSS patients where clinical, demographic, comorbidities and concomitant medications data are recorded. Patients were subclassified into the four NSST subgroups: Low Symptom Burden (LSB), High Symptom Burden (HSB), Dryness Dominated Fatigue (DDF) and Pain Dominated Fatigue (PDF). Group analyses of comorbid conditions and polypharmacy scores were performed. Comorbidity and Polypharmacy Scores (CPS) were modelled as a function of age, sex, symptom duration, body mass index (BMI), current immunosuppressant and hydroxychloroquine prescriptions and NSST subgroup. Results: There were marked differences in the number and the nature of comorbidities associated with the NSST subgroups. LSB and DDF patients were characterized by fewer comorbidities and medications. In contrast, HSB and PDF patients were associated with more comorbidities and were more likely to be prescribed multiple medications. Group analysis shows that HSB patients are more closely associated with peripheral vascular disease and infection whereas the PDF patients were associated with cardiovascular disease and gastrointestinal comorbidities. Comorbidity and polypharmacy scores increase with age and BMI regardless of symptom subgroup and symptom duration. In addition, the longer the reported symptom duration the higher the associated comorbidities and polypharmacy scores. Conclusion: Comorbid conditions are more prevalent in some subgroups of the PSS cohort but increase with age and BMI across the entire cohort. It is unclear from these data whether specific comorbid conditions are a consequence of PSS or represent shared aetiology or pathogenetic susceptibility. Regardless, these findings may have implications for disease management and clinical trial design.

Publication metadata

Author(s): Tarn J, Lendrem D, Barnes M, Casement J, Ng W-F

Publication type: Article

Publication status: Published

Journal: Frontiers in Immunology

Year: 2022

Volume: 13

Online publication date: 22/04/2022

Acceptance date: 22/03/2022

Date deposited: 29/07/2022

ISSN (electronic): 1664-3224

Publisher: Frontiers Media SA


DOI: 10.3389/fimmu.2022.864448

PubMed id: 35603172


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Funder referenceFunder name
806975IMI Joint Undertaking
Arthritis Research UK
National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre
NIHR Clinical Research Facility
Versus Arthritis Newcastle upon Tyne Experimental Arthritis Treatment Centre