Real-World Database Examining the Association between Sjögren's Syndrome and Chronic Rhinosinusitis.

Geng-He Chang,Yu-Cheng Chen,Ko-Ming Lin,Ching-Yuan Wu,Ming-Shao Tsai,Yao-Hsu Yang,Cheng-Ming Hsu,Meng-Hung Lin,Chia-Yen Liu

doi:10.3390/jcm8020155

Geng-He Chang, Yu-Cheng Chen + Show 7 more

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https://doi.org/10.3390/jcm8020155

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Abstract

Objective: To investigate the risk of chronic rhinosinusitis (CRS) among patients with Sjögren’s syndrome (SS). Method: A total of 18,723 patients diagnosed with SS between 1997 and 2011 were retrospectively analyzed. Moreover, 59,568 patients without SS were matched to patients with SS at a 1:4 ratio on the basis of sex, age, urbanization level, income level, and the comorbidities of rhinitis and nasal sepal deviation. Patients were followed up until death or the end of the study period (31 December, 2013). The primary outcome was the occurrence of CRS. Results: The cumulative incidence of CRS was significantly higher in patients with SS than in those without SS (p < 0.001). The adjusted Cox proportional hazard model showed that patients with SS had a significantly higher incidence of CRS (hazard ratio, 2.51; 95% confidence interval, 2.22–2.84; p < 0.001). Sensitivity and subgroup analyses demonstrated SS was an independent risk factor for CRS. The dosage of intranasal corticosteroid spray used was not different between the SS and non-SS groups. Fewer patients with CRS in the SS group underwent sinus surgery (82/407 (20.2%)) than those in the non-SS group (179/667 (26.8%)) and this finding was statistically significant (p = 0.013). The number of operations did not differ significantly between patients with CRS in the SS and non-SS groups. Conclusions: SS is an independent risk factor for CRS. Our study extends the disease spectrum and prompts physicians to be aware of potential CRS occurrence after SS.

Highlights

Chronic rhinosinusitis (CRS), one of the most common diseases globally, continues to have a negative impact on patients’ quality of life [1]
Sjögren’s syndrome (SS) is a chronic autoimmune disorder characterized by the lymphocytic infiltration of exocrine glands, the salivary and lacrimal glands, which can lead to xerostomia and keratoconjunctivitis sicca [3,4,5]
Among 59,568 patients without SS, 667 patients with CRS were identified in a mean observation period of 5.2 ± 3.53 years

Summary

Introduction

Chronic rhinosinusitis (CRS), one of the most common diseases globally, continues to have a negative impact on patients’ quality of life [1]. SS may involve dryness and chronic inflammation of the sinonasal mucosa, which may cause CRS [3]. Min et al reported systemic lupus erythematosus and rheumatoid arthritis as risk factors for CRS [6]. Lester et al found a strong association between sicca symptoms and CRS [3]. SS is a major autoimmune disease, and patients with SS present typical sicca symptoms. To the best of our knowledge, the risk of CRS among patients with SS remains unknown. In the present study, we investigated the effect of SS on the occurrence of CRS

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