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Research ArticleArticle

Prevalence, Risk, and Risk Factors for Oral and Ocular Dryness with Particular Emphasis on Rheumatoid Arthritis

FREDERICK WOLFE and KALEB MICHAUD
The Journal of Rheumatology June 2008, 35 (6) 1023-1030;
FREDERICK WOLFE
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  • For correspondence: fwolfe@arthritis-research.org
KALEB MICHAUD
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Abstract

Objective

To determine, primarily in rheumatoid arthritis (RA), the prevalence, relative risk, and risk factors for oral and ocular dryness.

Methods

We studied self-reported persistent ocular and oral dryness (PD) present in 2 consecutive observations, and sporadic dryness (SD) present in 1 of 2 consecutive observations, during semiannual assessments in 9921 patients with RA and in 2851 with a noninflammatory rheumatic disorder (NIRD) (not fibromyalgia; FM). We also evaluated prevalence in 2867 patients with FM.

Results

In RA, PD was noted in 11.6% and SD in 17.5%. Compared with NIRD, the age and sex adjusted relative risk (RR) for PD was 1.34 (95% CI 1.17–1.51) and the severity and treatment adjusted RR was 1.46 (95% CI 1.26–1.6). The adjusted RR for FM compared with RA and NIRD was 2.02 (95% CI 1.85–2.20). Dryness prevalence increased 10% to 13% every 10 years, and was associated with therapy. The treatment attributable risk was 27.5%. Fatigue and body pain (Symptom Intensity Scale) was more strongly associated with dryness than was any other clinical scale, including Health Assessment Questionnaire, pain, and Medical Outcomes Study Short Form-36 Health Survey. SD was associated with a covariate adjusted decrease in quality of life of 0.020 (95% CI 0.012–0.029) utility units.

Conclusion

Dryness is increased in RA and is contributed to by severity and therapy. The combination of body pain and fatigue is the strongest clinical correlate of dryness, and is independent of diagnosis of FM. Any factor that increases illness severity or distress results in an increase in dryness.

Key Indexing Terms:
  • DRYNESS
  • RHEUMATOID ARTHRITIS
  • RISK FACTORS
  • NONINFLAMMATORY RHEUMATIC DISORDERS
  • FIBROMYALGIA

Footnotes

  • F. Wolfe, MD, National Data Bank for Rheumatic Diseases and University of Kansas School of Medicine; K. Michaud, PhD, University of Nebraska Medical Center and National Data Bank for Rheumatic Diseases.

    • Accepted for publication January 14, 2008.
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The Journal of Rheumatology
Vol. 35, Issue 6
1 Jun 2008
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Prevalence, Risk, and Risk Factors for Oral and Ocular Dryness with Particular Emphasis on Rheumatoid Arthritis
FREDERICK WOLFE, KALEB MICHAUD
The Journal of Rheumatology Jun 2008, 35 (6) 1023-1030;

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Prevalence, Risk, and Risk Factors for Oral and Ocular Dryness with Particular Emphasis on Rheumatoid Arthritis
FREDERICK WOLFE, KALEB MICHAUD
The Journal of Rheumatology Jun 2008, 35 (6) 1023-1030;
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