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TOPLINE:

Patients with primary Sjögren disease (pSjD) are at an increased risk for early and more severe subclinical atherosclerosis, particularly those with organ involvement.

METHODOLOGY:

• Chronic inflammation contributes to atherosclerosis development and higher rates of cardiovascular events in patients with rheumatoid arthritis and systemic lupus erythematosus; however, despite cardiovascular disease being a leading cause of mortality, this association has been poorly studied in patients with pSjD.
• In this cross-sectional study, researchers assessed 199 patients with pSjD (median age, 58.9 years; 19.1% men; 115 with organ involvement) and 100 gender- and age-matched control participants.
• The levels of oxidized low-density lipoprotein (LDL) antibody were measured as a biomarker of vascular damage.
• Doppler ultrasound was performed to assess the extent of atherosclerotic plaque and carotid intima-media thickness.
• Correlations between oxidized LDL antibody levels and European Alliance of Associations for Rheumatology (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI) and anti–Sjögren's syndrome–related antigen A autoantibody (SSA/Ro antibody) levels were evaluated.

TAKEAWAY:

• Patients with pSjD had significantly greater carotid intima-media thickness (mean, 0.71 vs 0.65 mm; P < .001) and higher odds of developing plaque (odds ratio [OR], 1.82; 95% CI, 1.14-2.95) than controls.
• There was no difference in the carotid intima-media thickness between patients in their 50s and controls in their 60s, and patients in their 60s had higher thickness than controls in their 80s, indicating earlier onset and rapid progression in patients with pSjD.
• Patients with organ involvement had higher carotid intima-media thickness (mean, 0.73 vs 0.68 mm; P = .025) and risk for plaque (OR, 1.74; 95% CI, 1.02-3.01) than those without organ involvement.
• There was a significant correlation between higher oxidized LDL antibody levels and ESSDAI score as well as SSA/Ro antibody levels.

IN PRACTICE:

"Clinicians need to pay more attention to cardiovascular risk stratification in patients with [pSjD]," the authors wrote.

SOURCE:

This study was led by Nadine Zehrfeld, Rheumatology & Immunology, Hannover Medical School, Hanover, Germany, and was published online on April 24 in RMD Open.

LIMITATIONS:

This study included a high number of patients with organ manifestations and polyneuropathy and included a higher-than-normal percentage of men (19%). Cross-sectional study design limited follow-up assessments and investigation into the effect of drugs such as hydroxychloroquine. Moreover, differences in the use of glucocorticoids were not considered, which may have effects on vascular lesions and cardiovascular risk.

DISCLOSURES:

This study was funded by Novartis. The authors declared no relevant conflicts of interest. Some of the authors reported receiving scholarships, research grants, lecture honoraria, travel grants, and financial support for conference attendance and participation in advisory boards from various sources outside the submitted work.