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Sjögren’s disease activity associates with cardiovascular disease and monoclonal gammopathy: a university cohort study of disease activity and comorbidities

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Abstract

Background

We used the University of Wisconsin cohort to determine the extent to which the EULAR Sjögren’s syndrome disease activity index (ESSDAI) was associated with comorbidities that contribute to mortality.

Methods

Our University of Wisconsin, Madison cohort had 111 patients with Sjögren’s Disease (SjD) by 2016 ACR/EULAR criteria and 194 control patients with sicca. Our study was performed from March 1st, 2020 through April 1st, 2023. We collected data using a standardized collection tool, including components of the Charlson Comorbidity Index (CCI). Stratifying our SjD patients by ESSDAI < 5 and ESSDAI ≥ 5, we assessed differences in comorbidities associated with mortality.

Results

At time of SjD diagnosis, the ESSDAI ≥ 5 group had increased odds of peripheral vascular disease compared to controls (OR 10.17; 95% CI 1.18–87.87). Patients with a current ESSDAI ≥ 5 were more likely to have a myocardial infarction compared to controls (OR 9.87; 95% CI 1.17–83.49). SjD patients had increased prevalence of monoclonal gammopathy compared to controls (9.3% vs 0.5%, p < 0.001). SjD patients with high ESSDAI at diagnosis had greater prevalence of monoclonal gammopathy compared to the SjD patients with a low ESSDAI (16% vs 5%, p = .04). As reported elsewhere, the ESSDAI ≥ 5 group had increased odds of chronic pulmonary disease (OR 4.37; 95% CI 1.59–11.97).

Conclusion

We found high ESSDAI scores were associated with worse cardiovascular outcomes, specifically peripheral vascular disease and myocardial infarction. Furthermore, monoclonal gammopathy was more frequent in SjD patients compared to sicca controls, supporting screening for monoclonal gammopathy in the appropriate clinical scenario.

Key Points

• High ESSDAI scores are associated with worse cardiovascular outcomes, specifically peripheral vascular disease and myocardial infarction.

• Monoclonal gammopathy is more frequent in SjD patients than sicca controls, supporting screening for monoclonal gammopathy in the appropriate clinical scenario.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This work was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant 1KL2TR002374. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH

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Authors and Affiliations

  1. Department of Medicine, University of Wisconsin School of Medicine and Public Health, UW Medical Foundation Centennial Building, 1685 Highland Avenue, Madison, WI, 53705, USA

    Bradley R. Bohman, Hunter S. Dowds, Temisan E. Blagogee, Karen E. Hansen & Sara S. McCoy

  2. Department of Medicine, University of Michigan, Ann Arbor, MI, USA

    Robert W. Ike

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  1. Bradley R. Bohman
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  2. Hunter S. Dowds
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  3. Temisan E. Blagogee
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  6. Sara S. McCoy
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Contributions

BB analyzed, interpreted data, and was a major contributor to writing the manuscript. HD helped with data extraction, interpreting data, and contributed to writing the manuscript. TB helped with data extraction. KH helped with defining and identifying cohort and contributed in review of manuscript, SM helped with defining and identifying cohort, data analysis and writing of manuscript. All authors read, approved the final manuscript, and take responsibility for the content of this manuscript.

Corresponding author

Correspondence to Sara S. McCoy.

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Approval waived based on nature of study.

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Not applicable.

Financial disclosures

Support: This work was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant 1KL2TR002374. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Hunter S. Dowds received a summer research award from the Herman and Gwendolyn Shapiro Foundation in support of the research he provided.

Competing interests

All authors in this study deny relevant financial and nonfinancial competing interests. SSM receives unrelated consulting fees from Novartis, BMS, Otsuka, Visterra, Horizon, Kiniksa, Target RWE, iCell.

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Bohman, B.R., Dowds, H.S., Blagogee, T.E. et al. Sjögren’s disease activity associates with cardiovascular disease and monoclonal gammopathy: a university cohort study of disease activity and comorbidities. Clin Rheumatol 43, 1093–1101 (2024). https://doi.org/10.1007/s10067-024-06890-y

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