Autonomic symptoms are common and are associated with overall symptom burden and disease activity in primary Sjogren's syndrome

Julia L Newton, James Frith, Danielle Powell, Kate Hackett, Katharine Wilton, Simon Bowman, Elizabeth Price, Colin Pease, Jacqueline Andrews, Paul Emery, John Hunter, Monica Gupta, Saravanan Vadivelu, Ian Giles, David Isenberg, Peter Lanyon, Adrian Jones, Marian Regan, Annie Cooper, Robert MootsNurhan Sutcliffe, Michele Bombardieri, Costantino Pitzalis, John McLaren, Steven Young-Min, Bhaskar Dasgupta, Bridget Griffiths, Dennis Lendrem, Sheryl Mitchell, Wan-Fai Ng, UK Primary Sjögren's Syndrome Registry

Research output: Contribution to journalArticlepeer-review

46 Citations (Scopus)

Abstract

OBJECTIVES: To determine the prevalence of autonomic dysfunction (dysautonomia) among patients with primary Sjögren's syndrome (PSS) and the relationships between dysautonomia and other clinical features of PSS.

METHODS: Multicentre, prospective, cross-sectional study of a UK cohort of 317 patients with clinically well-characterised PSS. Symptoms of autonomic dysfunction were assessed using a validated instrument, the Composite Autonomic Symptom Scale (COMPASS). The data were compared with an age- and sex-matched cohort of 317 community controls. The relationships between symptoms of dysautonomia and various clinical features of PSS were analysed using regression analysis.

RESULTS: COMPASS scores were significantly higher in patients with PSS than in age- and sex-matched community controls (median (IQR) 35.5 (20.9-46.0) vs 14.8 (4.4-30.2), p<0.0001). Nearly 55% of patients (vs 20% of community controls, p<0.0001) had a COMPASS score >32.5, a cut-off value indicative of autonomic dysfunction. Furthermore, the COMPASS total score correlated independently with EULAR Sjögren's Syndrome Patient Reported Index (a composite measure of the overall burden of symptoms experienced by patients with PSS) (β=0.38, p<0.001) and disease activity measured using the EULAR Sjögren's Syndrome Disease Activity Index (β=0.13, p<0.009).

CONCLUSIONS: Autonomic symptoms are common among patients with PSS and may contribute to the overall burden of symptoms and link with systemic disease activity.

Original languageEnglish
Pages (from-to)1973-1979
Number of pages7
JournalAnnals of the Rheumatic Diseases
Volume71
Issue number12
DOIs
Publication statusPublished - Dec 2012

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