Ian J Saldanha1, Vatinee Y Bunya2, Sara S McCoy3, Matthew Makara4, Alan N Baer5, Esen K Akpek6. 1. Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, and Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA. Electronic address: ian_saldanha@brown.edu. 2. Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 3. Department of Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. 4. Sjögren's Foundation, Reston, Virginia, USA. 5. Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 6. The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Abstract
PURPOSE: To compare the burden related to dry eye with systemic symptoms of Sjögren syndrome; to estimate the burden related to ocular treatments; and to compare the impact of dry eye and extraocular manifestations of Sjögren syndrome on various aspects of patient life. DESIGN: Cross-sectional study. METHODS: We conducted a postal survey of adult patients with a history of physician-diagnosed Sjögren syndrome. RESULTS: The survey was completed by 2,961 patients (mean age 65.1 years, standard deviation 11.7 years), most of whom were women (96%) and white (94%). Forty-one patients younger than 18 years of age were excluded. More than half (53%) experienced severe dry eye (ie, dry eye daily/almost daily with major impact on their life). Corresponding proportions for dry mouth and fatigue were 48% and 45%, respectively. Almost all patients (97%) had used nonprescription eye drops/artificial tears/ointments. Compared with patients who did not experience dry eye, those who experienced significant dry eye (ie, daily/almost daily dry eye) more often agreed that living with Sjögren syndrome made every day a challenge (adjusted odds ratio [OR] 3.81, 95% confidence interval [CI] 2.49 to 5.86) and added a significant emotional burden (adjusted OR 2.22, 95% CI 1.49 to 3.31). Adjusted ORs for the impact of dry eye were generally lower than those for fatigue, but were similar to dry mouth and considerably higher than use of systemic treatments for serious manifestations of the disease and diagnosis of lymphoma. CONCLUSIONS: Sjögren-related dry eye is more burdensome than systemic manifestations of the disease. While fatigue has the greatest impact on patient life, the impact of dry eye is comparable to that of other systemic manifestations.
PURPOSE: To compare the burden related to dry eye with systemic symptoms of Sjögren syndrome; to estimate the burden related to ocular treatments; and to compare the impact of dry eye and extraocular manifestations of Sjögren syndrome on various aspects of patient life. DESIGN: Cross-sectional study. METHODS: We conducted a postal survey of adult patients with a history of physician-diagnosed Sjögren syndrome. RESULTS: The survey was completed by 2,961 patients (mean age 65.1 years, standard deviation 11.7 years), most of whom were women (96%) and white (94%). Forty-one patients younger than 18 years of age were excluded. More than half (53%) experienced severe dry eye (ie, dry eye daily/almost daily with major impact on their life). Corresponding proportions for dry mouth and fatigue were 48% and 45%, respectively. Almost all patients (97%) had used nonprescription eye drops/artificial tears/ointments. Compared with patients who did not experience dry eye, those who experienced significant dry eye (ie, daily/almost daily dry eye) more often agreed that living with Sjögren syndrome made every day a challenge (adjusted odds ratio [OR] 3.81, 95% confidence interval [CI] 2.49 to 5.86) and added a significant emotional burden (adjusted OR 2.22, 95% CI 1.49 to 3.31). Adjusted ORs for the impact of dry eye were generally lower than those for fatigue, but were similar to dry mouth and considerably higher than use of systemic treatments for serious manifestations of the disease and diagnosis of lymphoma. CONCLUSIONS: Sjögren-related dry eye is more burdensome than systemic manifestations of the disease. While fatigue has the greatest impact on patient life, the impact of dry eye is comparable to that of other systemic manifestations.
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Authors: Sara S McCoy; Christie M Bartels; Ian J Saldanha; Vatinee Y Bunya; Esen K Akpek; Matthew A Makara; Alan N Baer Journal: J Rheumatol Date: 2020-09-15 Impact factor: 5.346