Real-World Database Examining the Association between Sjögren’s Syndrome and Chronic Rhinosinusitis

Abstract

Objective: To investigate the risk of chronic rhinosinusitis (CRS) among patients with Sjögren’s syndrome (SS). Method: A total of 18,723 patients diagnosed with SS between 1997 and 2011 were retrospectively analyzed. Moreover, 59,568 patients without SS were matched to patients with SS at a 1:4 ratio on the basis of sex, age, urbanization level, income level, and the comorbidities of rhinitis and nasal sepal deviation. Patients were followed up until death or the end of the study period (31 December, 2013). The primary outcome was the occurrence of CRS. Results: The cumulative incidence of CRS was significantly higher in patients with SS than in those without SS (p < 0.001). The adjusted Cox proportional hazard model showed that patients with SS had a significantly higher incidence of CRS (hazard ratio, 2.51; 95% confidence interval, 2.22–2.84; p < 0.001). Sensitivity and subgroup analyses demonstrated SS was an independent risk factor for CRS. The dosage of intranasal corticosteroid spray used was not different between the SS and non-SS groups. Fewer patients with CRS in the SS group underwent sinus surgery (82/407 (20.2%)) than those in the non-SS group (179/667 (26.8%)) and this finding was statistically significant (p = 0.013). The number of operations did not differ significantly between patients with CRS in the SS and non-SS groups. Conclusions: SS is an independent risk factor for CRS. Our study extends the disease spectrum and prompts physicians to be aware of potential CRS occurrence after SS.

Real‐world evidence for increased deep neck infection risk in patients with rheumatoid arthritis

“…Moreover, patients with RA often have difficulty in maintaining oral hygiene due to their hand joint disorders . Furthermore, Sjögren syndrome is often concomitant with RA, and xerostomia can attenuate the immune defense of oral cavities . Therefore, oral infections such as dental caries and periodontitis are usually latent in patients with RA .…”

“…The government of Taiwan established the National Health Insurance Research Database (NHIRD) in 1996; as of 2018, the NHIRD covered 99.6% of Taiwan's population . The NHIRD provides medical claims data for all beneficiaries, including disease diagnoses during clinic visits and hospitalization, prescription drugs and doses, examinations, procedures, surgery, payments, resident locations, and income levels, which were generated during reimbursement for insurance in an electronic format .…”

“…This study was exempted from obtaining informed consent from the participants because the data were deidentified. All insurant information was unidentifiable, and this study did not violate their rights or adversely affect their welfare . All data are anonymous and deidentified by scrambling the identification codes to make the NHI reimbursement data suitable for public research.…”

“…Comorbidities were defined using ICD‐9‐CM codes recorded in the claims data: DM (ICD‐9‐CM code: 250), hypertension (HTN) (ICD‐9‐CM codes: 401–405), chronic kidney disease (CKD) (ICD‐9‐CM codes: 403, 404, 585, and 586), liver cirrhosis (LC) (ICD‐9‐CM codes: 571.2, 571.5–571.6), cerebrovascular accident (CVA) (ICD‐9‐CM codes: 430–438), coronary artery disease (CAD) (ICD‐9‐CM codes: 410–414), systemic lupus erythematosus (SLE) (ICD‐9‐CM codes: 710.0), Sjögren syndrome (SS) (ICD‐9‐CM codes: 710.2), and psoriasis (ICD‐9‐CM codes: 696.1, 696.1) . Medical comorbidities were included if they appeared at least once in the diagnoses of inpatients or at least three times in the diagnoses of outpatients.…”

Chronic Rhinosinusitis—An Update on Epidemiology, Pathogenesis and Management

“…This Special Issue of JCM includes two papers on disease-specific form of CRS. The study of Chang et al [ 18 ] examined the occurrence of CRS among patients with Sjögren’s syndrome (SS). A huge database was analyzed: 18,723 SS patients diagnosed between 1997 and 2011 were retrospectively reviewed.…”