4.4 Article

Clinical features and risk factors of Raynaud's phenomenon in primary Sjogren's syndrome

Journal

CLINICAL RHEUMATOLOGY
Volume 40, Issue 10, Pages 4081-4087

Publisher

SPRINGER LONDON LTD
DOI: 10.1007/s10067-021-05749-w

Keywords

Interstitial lung disease; Primary Sjogren' syndrome; Raynaud's phenomenon; Risk factors

Categories

Funding

  1. National Nature Science Foundation of China [81801630]
  2. National Nature Science Foundation of Hebei Province [H2018307047]

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The study aimed to investigate RP in pSS patients, finding that pSS patients with RP were younger, had higher disease activity, and higher prevalence of lung involvement. Furthermore, they had higher positivity rates for ANA, anti-RNP, and ACA antibodies. Lung involvement, anti-RNP positivity, and ACA were identified as prognostic factors for pSS-RP.
Objective The aim at the current study was to investigate the clinical characteristics and risk factors of Raynaud's phenomenon (RP) in patients with primary Sjogren's syndrome (pSS). Methods Retrospective analysis of the medical records of 333 new-onset pSS patients was performed. Demographic, clinical, and serological data were compared between individuals with and without RP. Logistic regression analysis was used to identify risk factors. Results RP was present in 11.41% of the pSS patients. pSS-RP patients were younger (49.74 +/- 14.56 years vs. 54.46 +/- 13.20 years, p=0.04) and exhibited higher disease activity (11 [5.75-15] vs. 7 [4-12], p=0.03) than those without. The prevalence of lung involvement was significantly higher in pSS patients with RP (60.53% vs. 17.29%; p<0.001). A significantly higher proportion of patients with pSS-RP tested positive about antinuclear (ANA), anti-RNP, and anti-centromere antibodies (ACA) compared to those without (p=0.003, <0.001, and 0.01, respectively). Multivariate analysis identified lung involvement (odds ratio [OR]=8.81, 95% confidence interval [CI] 2.02-38.47; p=0.04), anti-RNP positive status (OR=79.41, 95% CI 12.57-501.78; p<0.0001), as well as ACA (OR=13.17, 95% CI 2.60-66.72; p=0.002) as prognostic factors for pSS-RP. Conclusion The presence of RP defined a subset of pSS with a unique phenotype, manifesting as increased lung involvement and a higher frequency of anti-RNP antibodies and ACA, as well as greater disease activity. These results suggest that RP has clinical and prognostic value of pSS patients. Further prospective studies with a larger number of subjects are warranted to confirm our findings and assess the prognostic and treatment implications of RP in pSS patients.

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