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 Moots; Nurhan 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

doi:10.1136/annrheumdis-2011-201009

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

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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 language	English
Pages (from-to)	1973-1979
Number of pages	7
Journal	Annals of the Rheumatic Diseases
Volume	71
Issue number	12
DOIs	https://doi.org/10.1136/annrheumdis-2011-201009
Publication status	Published - Dec 2012

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Newton, J. L., Frith, J., Powell, D., Hackett, K., Wilton, K., Bowman, S., Price, E., Pease, C., Andrews, J., Emery, P., Hunter, J., Gupta, M., Vadivelu, S., Giles, I., Isenberg, D., Lanyon, P., Jones, A., Regan, M., Cooper, A., ... UK Primary Sjögren's Syndrome Registry (2012). Autonomic symptoms are common and are associated with overall symptom burden and disease activity in primary Sjogren's syndrome. Annals of the Rheumatic Diseases, 71(12), 1973-1979. https://doi.org/10.1136/annrheumdis-2011-201009

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

abstract = "OBJECTIVES: To determine the prevalence of autonomic dysfunction (dysautonomia) among patients with primary Sj{\"o}gren'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 Sj{\"o}gren'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 Sj{\"o}gren'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.",

keywords = "Aged, Autonomic Nervous System Diseases, Cost of Illness, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Prevalence, Prospective Studies, Regression Analysis, Severity of Illness Index, Sjogren's Syndrome, United Kingdom, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't",

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

year = "2012",

month = dec,

doi = "10.1136/annrheumdis-2011-201009",

language = "English",

volume = "71",

pages = "1973--1979",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

publisher = "BMJ",

number = "12",

}

Newton, JL, Frith, J, Powell, D, Hackett, K, Wilton, K, Bowman, S, Price, E, Pease, C, Andrews, J, Emery, P, Hunter, J, Gupta, M, Vadivelu, S, Giles, I, Isenberg, D, Lanyon, P, Jones, A, Regan, M, Cooper, A, Moots, R, Sutcliffe, N, Bombardieri, M, Pitzalis, C, McLaren, J, Young-Min, S, Dasgupta, B, Griffiths, B, Lendrem, D, Mitchell, S, Ng, W-F & UK Primary Sjögren's Syndrome Registry 2012, 'Autonomic symptoms are common and are associated with overall symptom burden and disease activity in primary Sjogren's syndrome', Annals of the Rheumatic Diseases, vol. 71, no. 12, pp. 1973-1979. https://doi.org/10.1136/annrheumdis-2011-201009

TY - JOUR

T1 - Autonomic symptoms are common and are associated with overall symptom burden and disease activity in primary Sjogren's syndrome

AU - Newton, Julia L

AU - Frith, James

AU - Powell, Danielle

AU - Hackett, Kate

AU - Wilton, Katharine

AU - Bowman, Simon

AU - Price, Elizabeth

AU - Pease, Colin

AU - Andrews, Jacqueline

AU - Emery, Paul

AU - Hunter, John

AU - Gupta, Monica

AU - Vadivelu, Saravanan

AU - Giles, Ian

AU - Isenberg, David

AU - Lanyon, Peter

AU - Jones, Adrian

AU - Regan, Marian

AU - Cooper, Annie

AU - Moots, Robert

AU - Sutcliffe, Nurhan

AU - Bombardieri, Michele

AU - Pitzalis, Costantino

AU - McLaren, John

AU - Young-Min, Steven

AU - Dasgupta, Bhaskar

AU - Griffiths, Bridget

AU - Lendrem, Dennis

AU - Mitchell, Sheryl

AU - Ng, Wan-Fai

AU - UK Primary Sjögren's Syndrome Registry

PY - 2012/12

Y1 - 2012/12

N2 - 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.

AB - 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.

KW - Aged

KW - Autonomic Nervous System Diseases

KW - Cost of Illness

KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Prevalence

KW - Prospective Studies

KW - Regression Analysis

KW - Severity of Illness Index

KW - Sjogren's Syndrome

KW - United Kingdom

KW - Journal Article

KW - Multicenter Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1136/annrheumdis-2011-201009

DO - 10.1136/annrheumdis-2011-201009

M3 - Article

C2 - 22562982

VL - 71

SP - 1973

EP - 1979

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 12

ER -

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

Abstract

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