RT Journal Article
SR Electronic
T1 Axial Articular Manifestations in Primary Sjögren Syndrome: Association With Spondyloarthritis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.200189
DO 10.3899/jrheum.200189
A1 Pierre-André Jarrot
A1 Robin Arcani
A1 Olivier Darmon
A1 Jean Roudier
A1 Raphael Cauchois
A1 Karin Mazodier
A1 Rodolphe Jeanz
A1 Nathalie Balandraud
A1 Gilles Kaplanski
YR 2020
UL http://www.jrheum.org/content/early/2021/03/24/jrheum.200189.abstract
AB Objective To assess the prevalence of axial articular manifestations (AAMs) in patients with primary Sjögren syndrome (pSS), to investigate whether these symptoms reveal an associated spondyloarthritis (SpA), and to assess their therapeutic management. Methods Among 148 consecutive patients with pSS fulfilling European League Against Rheumatism (EULAR)/American College of Rheumatology 2019 classification criteria followed between 2010 and 2018, we selected those who presented with AAMs. The association with SpA was retained when patients fulfilled Assessment of SpA international Society criteria. Results A total of 29 patients (20%, 28 women) with a median age of 43 years (range 15–65 yrs), were identified. The main extraglandular features were peripheral arthralgia and arthritis in 93% and 90% of patients, respectively. Positive anti-Ro/SSA (anti-SSA) antibody was reported in 62%. AAMs were inaugural in 7%, delayed from the diagnostic of pSS in 7%, and occurred concomitantly in 86% of patients. AAMs were not associated to multisystemic involvement of pSS. Radiographic sacroiliitis was mentioned in 65%, and HLA-B27 was positive in 13%. The diagnosis of SpA was retained in 23/29 patients (79%), among which 74% and 26% fulfilled psoriatic arthritis and ankylosing spondylitis criteria, respectively. There was no phenotypic difference according to the anti-SSA antibody status. With a median follow-up of 60 months (range: 5–96), 61% of patients with associated SpA required biotherapies, mainly of anti–tumor necrosis factor-α or anti–interleukin 17A molecules with a good clinical outcome in 64% and no effect on pSS. Conclusion AAMs are not uncommon in patients with pSS and may reveal an associated SpA. Treatment of AAMs, especially when clearly associated with SpA, may necessitate biologics, following SpA-management therapeutic guidelines.