Pilar Brito-Zerón1,2, Nihan Acar-Denizli3, Margit Zeher4, Astrid Rasmussen5, Raphaele Seror6, Elke Theander7, Xiaomei Li8, Chiara Baldini9, Jacques-Eric Gottenberg10, Debashish Danda11, Luca Quartuccio12, Roberta Priori13, Gabriela Hernandez-Molina14, Aike A Kruize15, Valeria Valim16, Marika Kvarnstrom17, Damien Sene18, Roberto Gerli19, Sonja Praprotnik20, David Isenberg21, Roser Solans22, Maureen Rischmueller23, Seung-Ki Kwok24, Gunnel Nordmark25, Yasunori Suzuki26, Roberto Giacomelli27, Valerie Devauchelle-Pensec28, Michele Bombardieri29, Benedikt Hofauer30, Hendrika Bootsma31, Johan G Brun32, Guadalupe Fraile33, Steven E Carsons34, Tamer A Gheita35, Jacques Morel36, Cristina Vollenveider37, Fabiola Atzeni38, Soledad Retamozo39, Ildiko Fanny Horvath4, Kathy Sivils5, Thomas Mandl7, Pulukool Sandhya11, Salvatore De Vita12, Jorge Sanchez-Guerrero14, Eefje van der Heijden15, Virginia Fernandes Moça Trevisani40, Marie Wahren-Herlenius17, Xavier Mariette6, Manuel Ramos-Casals2,41. 1. Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA- Sanitas, Barcelona, Spain. 2. Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Department of Autoimmune Diseases, ICMiD, University of Barcelona, Hospital Clínic, Barcelona, Spain. 3. Department of Statistics, Faculty of Science and Letters, Mimar Sinan Fine Arts University, Istanbul, Turkey. 4. Division of Clinical Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary. 5. Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA. 6. Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, Université Paris Sud, INSERM U1184, Paris, France. 7. Department of Rheumatology, Malmö University Hospital, Lund University, Lund, Sweden. 8. Department of Rheumatology and Immunology, Anhui Provincial Hospital, Hefei, China. 9. Rheumatology Unit, University of Pisa, Pisa, Italy. 10. Department of Rheumatology, Strasbourg University Hospital, Université de Strasbourg, CNRS, Strasbourg, France. 11. Department of Clinical Immunology & Rheumatology, Christian Medical College & Hospital, Vellore, India. 12. Clinic of Rheumatology, Department of Medical and Biological Sciences, University Hospital "Santa Maria della Misericordia", Udine, Italy. 13. Department of Internal Medicine and Medical Specialties, Rheumatology Clinic, Sapienza University of Rome, Rome, Italy. 14. Immunology and Rheumatology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. México City, Mexico. 15. Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands. 16. Department of Medicine, Federal University of Espírito Santo, Vitória, Brazil. 17. Department of Medicine, Solna, Unit of Experimental Rheumatology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden. 18. Département de Médecine Interne, Hôpital Lariboisière, Université Paris VII, Assistance Publique-Hôpitaux de Paris, Paris, France. 19. Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy. 20. Department of Rheumatology, University Medical Centre, Ljubljana, Slovenia. 21. Division of Medicine, Centre for Rheumatology, University College London, London, UK. 22. Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain. 23. Department of Rheumatology, The Queen Elizabeth Hospital, Discipline of Medicine University of Adelaide, South Australia. 24. Division of Rheumatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. 25. Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. 26. Division of Rheumatology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan. 27. Clinical Unit of Rheumatology, School of Medicine, University of l'Aquila, L'Aquila, Italy. 28. Rheumatology Department, Brest University Hospital, Brest, France. 29. Centre for Experimental Medicine and Rheumatology, Queen Mary University of London, London, UK. 30. Otorhinolaryngology / Head and Neck Surgery, Technical University Munich, Munich, Germany. 31. Department of Rheumatology & Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 32. Department of Clinical Science, University of Bergen; and Department of Rheumatology, Haukeland University Hospital, Bergen, Norway. 33. Department of Internal Medicine, Hospital Ramón y Cajal, Madrid, Spain. 34. Division of Rheumatology, Allergy and Immunology Winthrop-University Hospital, Stony Brook University School of Medicine, Mineola, New York, USA. 35. Rheumatology Department, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt. 36. Department of Rheumatology, Teaching hospital and University of Montpellier, Montpellier, France. 37. German Hospital, Buenos Aires, Argentina. 38. IRCCS Galeazzi Orthopedic Institute, Milan, Italy. 39. Hospital Privado Universitario de Córdoba, Institute University of Biomedical Sciences University of Córdoba (IUCBC), Cordoba, Argentina. 40. Federal University of São Paulo, Sao Paulo, Brazil. 41. Department of Medicine, University of Barcelona, Barcelona, Spain.
Abstract
OBJECTIVES: To analyse the influence of geolocation and ethnicity on the clinical presentation of primary Sjögren's syndrome (SjS) at diagnosis. METHODS: The Big Data Sjögren Project Consortium is an international, multicentre registry designed in 2014. By January 2016, 20 centres from five continents were participating. Multivariable logistic regression analyses were performed. RESULTS: We included 7748 women (93%) and 562 men (7%), with a mean age at diagnosis of primary SjS of 53 years. Ethnicity data were available for 7884 patients (95%): 6174 patients (78%) were white, 1066 patients (14%) were Asian, 393 patients (5%) were Hispanic, 104 patients (1%) were black/African-American and 147 patients (2%) were of other ethnicities. SjS was diagnosed a mean of 7 years earlier in black/African-American compared with white patients; the female-to-male ratio was highest in Asian patients (27:1) and lowest in black/African-American patients (7:1); the prevalence of sicca symptoms was lowest in Asian patients; a higher frequency of positive salivary biopsy was found in Hispanic and white patients. A north-south gradient was found with respect to a lower frequency of ocular involvement in northern countries for dry eyes and abnormal ocular tests in Europe (OR 0.46 and 0.44, respectively) and Asia (OR 0.18 and 0.49, respectively) compared with southern countries. Higher frequencies of antinuclear antibodies (ANAs) were reported in northern countries in America (OR=1.48) and Asia (OR=3.80) while, in Europe, northern countries had lowest frequencies of ANAs (OR=0.67) and Ro/La (OR=0.69). CONCLUSIONS: This study provides the first evidence of a strong influence of geolocation and ethnicity on the phenotype of primary SjS at diagnosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVES: To analyse the influence of geolocation and ethnicity on the clinical presentation of primary Sjögren's syndrome (SjS) at diagnosis. METHODS: The Big Data Sjögren Project Consortium is an international, multicentre registry designed in 2014. By January 2016, 20 centres from five continents were participating. Multivariable logistic regression analyses were performed. RESULTS: We included 7748 women (93%) and 562 men (7%), with a mean age at diagnosis of primary SjS of 53 years. Ethnicity data were available for 7884 patients (95%): 6174 patients (78%) were white, 1066 patients (14%) were Asian, 393 patients (5%) were Hispanic, 104 patients (1%) were black/African-American and 147 patients (2%) were of other ethnicities. SjS was diagnosed a mean of 7 years earlier in black/African-American compared with white patients; the female-to-male ratio was highest in Asian patients (27:1) and lowest in black/African-American patients (7:1); the prevalence of sicca symptoms was lowest in Asian patients; a higher frequency of positive salivary biopsy was found in Hispanic and white patients. A north-south gradient was found with respect to a lower frequency of ocular involvement in northern countries for dry eyes and abnormal ocular tests in Europe (OR 0.46 and 0.44, respectively) and Asia (OR 0.18 and 0.49, respectively) compared with southern countries. Higher frequencies of antinuclear antibodies (ANAs) were reported in northern countries in America (OR=1.48) and Asia (OR=3.80) while, in Europe, northern countries had lowest frequencies of ANAs (OR=0.67) and Ro/La (OR=0.69). CONCLUSIONS: This study provides the first evidence of a strong influence of geolocation and ethnicity on the phenotype of primary SjS at diagnosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: R Hal Scofield; Rohan Sharma; Nathan Pezant; Jennifer A Kelly; Lida Radfar; David M Lewis; C Erick Kaufman; Sarah Cioli; Judy Harris; Kiely Grundahl; Nelson L Rhodus; Daniel J Wallace; Michael H Weisman; Swamy Venuturupalli; Michael T Brennan; Kristi A Koelsch; Christopher J Lessard; Courtney G Montgomery; Kathy L Sivils; Astrid Rasmussen Journal: Arthritis Care Res (Hoboken) Date: 2020-07-05 Impact factor: 4.794