Seminars in arthritis and rheumatism · 2025
Autonomic dysfunction symptoms in Sjögren's Disease: A missed dimension linked to disease burden and work disability.
СтатьяНазвание и аннотация: Перевод в очереди
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Achten Helena, Liselotte Deroo, Sophie Vanhoof, Kristel De Boeck, Joke Deprez, Emilie Dumas, Eva Genbrugge, Wouter Bauters, Dimitri Roels, Frederick Dochy, David Creytens, Dirk Elewaut, Isabelle Peene
Аннотация
BACKGROUND: Autonomic dysfunction (AD) has been reported in Sjögren's Disease (SjD), but its relationship with established objective and patient-reported outcome measures (PROMs) is unclear.
OBJECTIVES: The primary aim was to assess AD symptoms in a large SjD cohort and to examine their association with established SjD outcome measures. Secondary, the relationship between AD symptoms and symptom-based endotypes, work disability, and vaginal dryness was evaluated.
METHODS: The Composite Autonomic Symptom Score 31 (COMPASS-31) was completed by 266 SjD patients from the Belgian Sjögren's Syndrome Transition Trial. Objective measures included glandular involvement (ultrasound, focus score, sicca tests) and systemic disease activity (European Alliance of Associations for Rheumatology (EULAR) Sjögren's Syndrome Disease Activity Index). PROMs included EULAR patient reported index, Hospital Anxiety and Depression scale, modified fatigue Impact scale, vaginal dryness and profession. The Newcastle Sjögren's Stratification Tool stratified patients into 'Low Symptom Burden', 'Dryness Dominant with Fatigue', 'Pain Dominant with Fatigue (PDF)' and 'High Symptom Burden (HSB)'.
RESULTS: COMPASS-31 did not correlate with objective measures, but showed significant associations with anxiety (ρ = 0.41), depression (ρ = 0.44), pain (ρ = 0.35), dryness (ρ = 0.29) and fatigue (ρ = 0.37), (p < 0.001). Integrating these PROMS into symptom-based endotypes, COMPASS-31 was highest in HSB and PDF (p < 0.001). COMPASS-31 independently predicted work disability (OR 2.10, 95 % CI 1.29-3.44, p < 0.01) and was higher in premenopausal women with vaginal dryness (p < 0.01).
CONCLUSION: AD symptoms are not captured by established outcome measures but meaningfully contribute to disease burden and work disability. COMPASS-31 may serve as a valuable complementary PROM. Future studies should objectify AD and clarify its pathophysiology.
OBJECTIVES: The primary aim was to assess AD symptoms in a large SjD cohort and to examine their association with established SjD outcome measures. Secondary, the relationship between AD symptoms and symptom-based endotypes, work disability, and vaginal dryness was evaluated.
METHODS: The Composite Autonomic Symptom Score 31 (COMPASS-31) was completed by 266 SjD patients from the Belgian Sjögren's Syndrome Transition Trial. Objective measures included glandular involvement (ultrasound, focus score, sicca tests) and systemic disease activity (European Alliance of Associations for Rheumatology (EULAR) Sjögren's Syndrome Disease Activity Index). PROMs included EULAR patient reported index, Hospital Anxiety and Depression scale, modified fatigue Impact scale, vaginal dryness and profession. The Newcastle Sjögren's Stratification Tool stratified patients into 'Low Symptom Burden', 'Dryness Dominant with Fatigue', 'Pain Dominant with Fatigue (PDF)' and 'High Symptom Burden (HSB)'.
RESULTS: COMPASS-31 did not correlate with objective measures, but showed significant associations with anxiety (ρ = 0.41), depression (ρ = 0.44), pain (ρ = 0.35), dryness (ρ = 0.29) and fatigue (ρ = 0.37), (p < 0.001). Integrating these PROMS into symptom-based endotypes, COMPASS-31 was highest in HSB and PDF (p < 0.001). COMPASS-31 independently predicted work disability (OR 2.10, 95 % CI 1.29-3.44, p < 0.01) and was higher in premenopausal women with vaginal dryness (p < 0.01).
CONCLUSION: AD symptoms are not captured by established outcome measures but meaningfully contribute to disease burden and work disability. COMPASS-31 may serve as a valuable complementary PROM. Future studies should objectify AD and clarify its pathophysiology.