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Prevalence of hearing loss in patients with Sjögren syndrome: a systematic review and meta-analysis.Rheumatology International Feb 2023Sjögren syndrome (SS) is a multisystem autoimmune disease, primarily targeting salivary and lacrimal glands; skin, nasal and vaginal dryness, along with musculoskeletal... (Meta-Analysis)
Meta-Analysis
Sjögren syndrome (SS) is a multisystem autoimmune disease, primarily targeting salivary and lacrimal glands; skin, nasal and vaginal dryness, along with musculoskeletal pain and fatigue are the most commonly reported symptoms. Hearing loss is hypothesized to be frequent as well. The purpose of this systematic review was to estimate the prevalence of Hearing loss and its different subtypes in patients with Sjögren syndrome. PRISMA guidelines were followed to ensure highest quality for our systematic review. A random effects model meta-analysis and meta-regression was conducted using I as heterogeneity indicator. Eleven observational studies were included in this systematic review. Ten of them were cross-sectional, while one study was case-control. Studies were assessed for risk of bias: all were rated to a moderate level, except for two rated to a low level. Pooled prevalence of any type of hearing loss was 52.2%. After excluding studies rated to moderate bias, the pooled prevalence of hearing loss was 36.7%. We also conducted a subgroup analysis depending on type of hearing loss. Pooled prevalence of sensorineural hearing loss was 42.6%., while pooled prevalence of conductive hearing loss and mixed hearing loss were 5% and 2.3%, respectively. Meta-regression was conducted in an effort to identify possible variables capable to explain high heterogeneity between studies. Sample size and year of study were separately found to account for a portion of heterogeneity between studies of sensorineural hearing loss. Year of study was also found to account for a portion of heterogeneity between studies of conductive hearing loss. In conclusion, sensorineural hearing loss, is highly prevalent in patients with Sjögren syndrome. On this basis, early screening and follow-up of patients with Sjögren syndrome by pure tone audiometry is important.
Topics: Female; Humans; Hearing Loss, Conductive; Sjogren's Syndrome; Prevalence; Hearing Loss; Hearing Loss, Sensorineural
PubMed: 36305918
DOI: 10.1007/s00296-022-05235-9 -
RMD Open Aug 2023To identify the best evidence on the efficacy of non-pharmacological interventions in reducing fatigue in people with inflammatory rheumatic and musculoskeletal diseases...
Efficacy of non-pharmacological interventions: a systematic review informing the 2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases.
OBJECTIVE
To identify the best evidence on the efficacy of non-pharmacological interventions in reducing fatigue in people with inflammatory rheumatic and musculoskeletal diseases (I-RMDs) and to summarise their safety in the identified studies to inform European Alliance of Associations for Rheumatology recommendations for the management of fatigue in people with I-RMDs.
METHODS
Systematic review of randomised controlled trials (RCTs) including adults with I-RMDs conducted according to the Cochrane Handbook. Search strategy ran in Medline, Embase, Cochrane Library, CINAHL Complete, PEDro, OTseeker and PsycINFO. Assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. Data were pooled in meta-analyses.
RESULTS
From a total of 4150 records, 454 were selected for full-text review, 82 fulfilled the inclusion criteria and 55 RCTs were included in meta-analyses. Physical activity or exercise was efficacious in reducing fatigue in rheumatoid arthritis (RA) (standardised mean differences (SMD)=-0.23, 95% CI=-0.37 to -0.1), systemic lupus erythematosus (SLE) (SMD=-0.54, 95% CI=-1.07 to -0.01) and spondyloarthritis (SMD=-0.94, 95% CI=-1.23 to -0.66); reduction of fatigue was not significant in Sjögren's syndrome (SMD=-0.83, 95% CI=-2.13 to 0.47) and systemic sclerosis (SMD=-0.66, 95% CI=-1.33 to 0.02). Psychoeducational interventions were efficacious in reducing fatigue in RA (SMD=-0.32, 95% CI=-0.48 to -0.16), but not in SLE (SMD=-0.19, 95% CI=-0.46 to 0.09). Follow-up models in consultations (SMD=-0.05, 95% CI=-0.29 to 0.20) and multicomponent interventions (SMD=-0.20, 95% CI=-0.53 to 0.14) did not show significant reductions of fatigue in RA. The results of RCTs not included in the meta-analysis suggest that several other non-pharmacological interventions may provide a reduction of fatigue, with reassuring safety results.
CONCLUSIONS
Physica activity or exercise and psychoeducational interventions are efficacious and safe for managing fatigue in people with I-RMDs.
Topics: Adult; Humans; Arthritis, Rheumatoid; Exercise; Lupus Erythematosus, Systemic; Musculoskeletal Diseases; Rheumatology
PubMed: 37604639
DOI: 10.1136/rmdopen-2023-003350 -
The Journal of Investigative Dermatology May 2023Vitiligo has been reported to be associated with a variety of diseases, but it has not been systematically reviewed. Therefore, we aimed to identify prevalent diseases... (Meta-Analysis)
Meta-Analysis
Vitiligo has been reported to be associated with a variety of diseases, but it has not been systematically reviewed. Therefore, we aimed to identify prevalent diseases in patients with vitiligo and quantify their associations compared with those in healthy controls. A comprehensive search of MEDLINE and EMBASE from the inception to June 2022 was conducted. Observational studies on prevalent diseases in patients with vitiligo compared with those in healthy controls were included, whereas studies limited to pediatrics or providing only laboratory results were excluded. A total of 78 studies were eligible for analyses. Patients with vitiligo showed higher risks of having comorbid autoimmune and connective tissue diseases, including alopecia areata (OR = 2.63, 95% confidence interval [CI] = 2.50‒2.78), discoid lupus erythematosus (OR = 2.54, 95% CI = 1.74‒3.72), Sjogren's syndrome (OR = 2.50, 95% CI = 1.98‒3.16), myasthenia gravis (OR = 2.30, 95% CI = 1.74‒3.02), systemic lupus erythematosus (OR = 1.96, 95% CI = 1.52‒2.52), and rheumatoid arthritis (OR = 1.82, 95% CI = 1.55‒2.15). Thyroid diseases, diabetes mellitus, metabolic syndrome, sensorineural hypoacusis, and ophthalmic abnormalities were also more prevalent in patients with vitiligo. In conclusion, vitiligo is associated with various systemic diseases. Physicians should evaluate and manage potential comorbid conditions in patients with vitiligo.
Topics: Humans; Child; Vitiligo; Comorbidity; Sjogren's Syndrome; Lupus Erythematosus, Systemic; Thyroid Diseases; Autoimmune Diseases
PubMed: 36574529
DOI: 10.1016/j.jid.2022.10.021 -
Frontiers in Immunology 2023Parkinson's disease (PD) is a neurodegenerative disorder that frequently occurs in the older population. Previous epidemiological studies have suggested an association... (Meta-Analysis)
Meta-Analysis
UNLABELLED
Parkinson's disease (PD) is a neurodegenerative disorder that frequently occurs in the older population. Previous epidemiological studies have suggested an association between PD and autoimmune diseases (AIDs). However, some studies have shown conflicting results. This study aimed to summarize existing epidemiological studies on the association between PD with AIDs and to conduct a meta-analysis of combinable results. Four electronic databases (PubMed, Embase, Web of Science Core Collection, and MEDLINE) were searched from each database's inception date until December 12, 2022. All studies that explored the relationship between PD and AIDs were included for quantitative analysis and qualitative review. The pooled relative risk with 95% confidence intervals (CIs) was calculated using a random or fixed effects model. A total of 46 observational studies involving 873,643 patients and 13,402,821 controls were included; ultimately, 38 studies were included in the meta-analysis. The risk of PD combined with AIDs was significantly higher (odds ratio [OR]=1.55, 95% CI: 1.33-1.81), and subgroup analysis found no significant differences in risk by study type, gender, age, and race. Regarding the AID types, the results showed an increased risk of PD combined with bullous pemphigoid (OR=2.67, 95% CI: 2.15-3.31), inflammatory bowel disease (OR=1.30, 95% CI: 1.18-1.45), Crohn's disease (OR=1.30, 95% CI: 1.20-1.42), ulcerative colitis (OR=1.31, 95% CI: 1.14-1.50), Sjögren's syndrome (OR=1.61, 95% CI: 1.24-2.09), and Graves' disease (OR=1.45, 95% CI: 1.24-1.70) than controls. However, there appeared to be no significant association between PD and systemic lupus erythematosus (OR=0.82, 95% CI: 0.66-1.03), multiple sclerosis (OR=2.02, 95% CI: 0.87-4.70), rheumatoid arthritis (OR=0.79, 95% CI: 0.61-1.03), or celiac disease (OR=1.16, 95% CI: 0.79-1.69). This study supports the existence of a strong link between AIDs and PD. When PD and AIDs are identified, clinicians need to be aware of the possibility of coexistence. However, there are some limitations of this study, such as the apparent heterogeneity of some of the results and the fact that most of the included study types were retrospective. Therefore, future larger prospective cohort studies are needed to further explore the interaction between PD and AIDs.
SYSTEMATIC REVIEW REGISTRATION
INPLASY, identifier INPLASY202280088.
Topics: Humans; Parkinson Disease; Prospective Studies; Retrospective Studies; Autoimmune Diseases; Sjogren's Syndrome
PubMed: 36761731
DOI: 10.3389/fimmu.2023.1103053 -
Clinical and Experimental Rheumatology 2018Acute systemic inflammation and chronic systemic vasculitis are associated with endothelial dysfunction and atherosclerotic plaque formation. Studies on cardiovascular... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Acute systemic inflammation and chronic systemic vasculitis are associated with endothelial dysfunction and atherosclerotic plaque formation. Studies on cardiovascular or cerebrovascular events in primary Sjögren's syndrome (pSS) are limited, with conflicting results. This meta-analysis aimed to explore the risk of cardiovascular and cerebrovascular disease in pSS.
METHODS
A comprehensive search of the MEDLINE and EMBASE databases was performed from date of inception through August 2017. The inclusion criterion was observational studies evaluating the association between pSS and cardiovascular disease or cerebrovascular event. Outcomes are diagnosis of ischaemic heart disease, myocardial infarction, ischaemic stroke or haemorrhagic stroke. The pooled odds ratio (OR) of the cerebrovascular event or cardiovascular disease and their 95% confidence interval (CI) were calculated using a random-effect meta-analysis to compare risk between patients with pSS and controls. The between-study heterogeneity of effect-size was quantified using the Q statistic and I2.
RESULTS
Data were extracted from 10 observational studies involving 165,291 subjects. Pooled result demonstrated a significant increase in risk of having cardiovascular disease or cerebrovascular event in pSS patients compared with controls (OR=1.28; 95% CI: 0.11-1.46, p value<0.01, I2=68%). Subgroup analyses showed no difference in risk for cerebrovascular event (OR=1.31; 95% CI: 0.96-1.79, p value=0.09, I2=71%), but an increased risk of cardiovascular disease (OR=1.30; 95% CI: 1.09-1.55, p value=0.003, I2=74%).
CONCLUSIONS
Our study has shown an increased risk of cardiovascular or cerebrovascular disease in patients with pSS. These results support multiple studies' finding of increased arterial stiffness in patients with pSS.
Topics: Adult; Aged; Cardiovascular Diseases; Cerebrovascular Disorders; Chi-Square Distribution; Female; Humans; Male; Middle Aged; Observational Studies as Topic; Odds Ratio; Prognosis; Risk Assessment; Risk Factors; Sjogren's Syndrome
PubMed: 29600936
DOI: No ID Found -
European Journal of Internal Medicine Apr 2024Currently, the guidelines for prevention and management of atherosclerosis in patients with Sjogren's syndrome (SS) do not differentiate from those concerning the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Currently, the guidelines for prevention and management of atherosclerosis in patients with Sjogren's syndrome (SS) do not differentiate from those concerning the general population.
OBJECTIVES
The present systematic review aimed to summarize evidence from primary studies assessing the risk of subclinical atherosclerosis in patients with primary SS (pSS).
METHODS AND RESULTS
Literature was searched until June 2023. Eligible records were randomized controlled trials and observational studies comparing subclinical atherosclerosis markers between pSS patients and healthy controls. DerSimonian-Laird random effects models were used to calculate overall effect estimates. Totally, 19 observational studies comprising 1625 participants were included. Compared to healthy controls, pSS patients had significantly higher values of carotid-femoral intima-media thickness (cfIMT) (MD= 0.07 mm; 95 % CI= [0.04, 0.11]; p <0.001) and were more frequently diagnosed with atherosclerotic plaques (OR= 1.9; 95 % CI= [1.32, 2.74]; p <0.001). Moreover, pSS patients showed a decreased flow and nitrate-mediated dilation (MD = -2.48 %; 95 % CI= [-4.57, -0.39]; p = 0.02, MD= -2.11 %; 95 % CI= [-3.22, -1.01]; p <0.001, respectively). Similar results were observed for the pulse-wave velocity (MD= 0.7 m/s; 95 % CI= [0.36, 1.05]; p <0.001) and the ankle-brachial index (OR= 5.78; 95 % CI= [2.23, 14.99]; p = 0.003). Based on meta-regression analyses, only the disease duration and erythrocyte sedimentation rate were positively and significantly associated with higher cfIMT values.
CONCLUSION
Patients with pSS have an increased risk of subclinical atherosclerosis compared to healthy population and thus possibly require early and disease-specific intervention. Further research is warranted for more accurate cardiovascular risk management in SS.
Topics: Humans; Sjogren's Syndrome; Carotid Intima-Media Thickness; Atherosclerosis; Risk Factors; Randomized Controlled Trials as Topic
PubMed: 37977997
DOI: 10.1016/j.ejim.2023.11.007 -
International Immunopharmacology Jul 2022There is a lack of single marker reflecting systemic activity of primary Sjögren's syndrome (pSS). Our aim is to determine the association between interleukin(IL)-7 and...
BACKGROUND
There is a lack of single marker reflecting systemic activity of primary Sjögren's syndrome (pSS). Our aim is to determine the association between interleukin(IL)-7 and pSS by combining a single-center study and a systematic scoping review.
METHODS
There were 58 patients with pSS and 30 healthy controls (HCs) included in the single-center study. The multiplex immunoassay was used for detecting concentrations of IL-7, IL-4, IL-9, IL-10, IL-17, interferon(IFN) -γ, INF-α and INF-β in sera. pSS patients were evaluated for systemic activity in accordance with the European League against Rheumatism SS Disease Activity Index (ESSDAI). In the systematic scoping review, all studies regarding association of IL-7 with pSS were included.
RESULTS
pSS patients showed higher serum IL-7 levels (P = 0.028 vs HCs) which were associated with neutrophil, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphacyte ratio(PLR), red blood cell distribution width(RDW), erythrocyte sedimentation rate(ESR), immunoglobulin(Ig)G, C-reactive protein (CRP), fever, lymphadenopathy and ESSDAI. Serum IL-7 correlated with Th cell related cytokines. Findings of the systematic scoping review on 15 articles were as follows. Firstly, IL-7 expression in salivary glands (SGs), serum and saliva increased in pSS, while IL-7 receptor(IL-7R) expression increased in SGs but decreased in peripheral blood. Secondly, increased IL-7 was mainly from SGs of pSS patients, but whether IL-7 was mainly produced by SG epithelial cells remained to be validated. Thirdly, IL-7 could exert a key role in pSS immunopathology. Although IL-7 had no direct effect on SGECs, it could activate B and T cells and stimulate secretion of IL-17, IL-4 and IFNs.
CONCLUSION
Not only are IL-7 and soluble IL-7R potential biomarkers for monitoring pSS activity, but also targeting IL-7/IL-7R pathway may be a promising therapeutic strategy.
Topics: Biomarkers; Case-Control Studies; Humans; Interleukin-17; Interleukin-4; Interleukin-7; Salivary Glands; Sjogren's Syndrome
PubMed: 35405597
DOI: 10.1016/j.intimp.2022.108758 -
Frontiers in Integrative Neuroscience 2022Evidence from observational studies suggests that Sjögren's syndrome (SS) may contribute to an elevated risk of Parkinson's disease (PD) and dementia. However, few...
OBJECTIVE
Evidence from observational studies suggests that Sjögren's syndrome (SS) may contribute to an elevated risk of Parkinson's disease (PD) and dementia. However, few studies have been undertaken to summarize and assess the consistency of the data quantitatively. Therefore, we evaluated the risk of dementia and PD in SS patients through a systematic review and meta-analysis approach.
METHODS
Two reviewers independently conducted a systematic search of PubMed, Embase, and Web of Science databases (updated to February 14, 2022) to identify published literature on the association between SS and dementia or PD. The risk estimates of dementia or PD in patients with SS were pooled using fixed or random-effects models.
RESULTS
Of the 631 studies initially searched, 10 were eventually included. Pooled results suggested that the risk of developing dementia significantly increased in patients with SS (HR = 1.24, 95% CI: 1.15-1.33, < 0.001), and such risk in females with SS was similar to that in males. The risk of PD was 1.36 times higher in SS (HR = 1.36, 95% CI: 1.23-1.50, < 0.001). The association between SS and PD risk appeared to occur primarily in female patients (female: HR = 1.28, 95% CI: 1.21-1.35; < 0.001 vs. male: HR = 1.00, 95% CI: 0.87-1.16, = 0.962, respectively). No significant effect of age was observed on the risk of developing PD and dementia in SS patients.
CONCLUSION
Our study supports that people with SS are at higher risk of PD and dementia than the general population. Further studies are needed to elucidate the underlying mechanisms and to assess whether interventions for SS have the potential to affect dementia and PD development.
PubMed: 36420122
DOI: 10.3389/fnint.2022.1027044 -
Frontiers in Immunology 2022Primary Sjögren's syndrome (pSS) and breast cancer are a highly prevalent autoimmune disease and malignancy, respectively, both occurring predominantly in females.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Primary Sjögren's syndrome (pSS) and breast cancer are a highly prevalent autoimmune disease and malignancy, respectively, both occurring predominantly in females. Whether there is a link between these two diseases is uncertain. We conducted a systematic review and meta-analysis to investigate the risk, incidence, and mortality of breast cancer in patients with pSS.
METHODS
We systematically searched Embase, PubMed, and Web of Science on January 31, 2022 to identify the study that assessed risk, incidence, or mortality of breast cancer in pSS. The fixed or random-effects models were applied to pool the effect estimates based on heterogeneity measured by Cochran's Q-test and Higgins' I.
RESULTS
Ten studies involving 725,805 participants and 64,836 pSS patients were included in our analysis. The pooled result showed that, overall, pSS was not associated with the risk (SIR=0.92, 95%CI: 0.66-1.29, =0.646) and mortality (HR = 0.78, 95%CI: 0.26-2.34, = 0.664) of breast cancer; however, when stratified by geographic region, we found that patients with pSS in Asian countries (SIR=1.32, 95%CI: 1.10-1.58, =0.003) and Argentina (SIR=3.76, 95%CI: 1.04-9.45, =0.019) had an elevated risk of breast cancer, while pSS in Europe was associated with a reduced risk (SIR=0.61, 95%CI: 0.51-0.73, <0.001). The pooled result from 28,635 female pSS patients indicated that the incidence of breast cancer was 2.15 (95% CI: 1.33-3.50) per 1000 person/years.
CONCLUSION
This study suggests that there may be geographical differences in the association between pSS and breast cancer risk; patients with pSS in European countries are associated with a lower risk of breast cancer, while Asia and Argentina are the opposite. Future research is needed to further characterize the effect of pSS on breast cancer risk and the pathophysiological mechanisms underlying this association to unravel the complex relationship between the two.
Topics: Autoimmune Diseases; Breast Neoplasms; Female; Humans; Incidence; Risk; Sjogren's Syndrome
PubMed: 35844507
DOI: 10.3389/fimmu.2022.904682 -
Acta Neurologica Belgica Apr 2022Primary Sjögren's syndrome (pSS) is a chronic autoimmune disorder characterized by lymphocytic infiltrates of the exocrine glands, particularly the salivary and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Primary Sjögren's syndrome (pSS) is a chronic autoimmune disorder characterized by lymphocytic infiltrates of the exocrine glands, particularly the salivary and lacrimal glands, resulting in oral and ocular dryness. pSS has been linked to various neurological manifestations, including cerebellar dysfunction. We aimed to provide a comprehensive analysis of the currently available evidence regarding pSS-related cerebellar ataxia.
METHODS
A systematic literature search in the PubMed database was performed and 19 papers were eligible to be included in this paper.
RESULTS
The pooled prevalence of cerebellar ataxia in pSS is estimated to be 1.5% (95% CI 0.3-6.8%). pSS patients with cerebellar involvement have a female-to-male ratio of 6:1. Although most of the patients are adults in their fifth decade of life when diagnosed, cases of children with pSS and cerebellar involvement have been reported. Typical cerebellar ataxia related to pSS manifests with vermian dysfunction, namely gait ataxia and/or cerebellar speech. Cerebellar ataxia due to pSS may also mimic degenerative cerebellar ataxia, especially when the onset is progressive.
CONCLUSIONS
The diagnostic approach to a patient with cerebellar ataxia of unknown etiology should include evaluation for an underlying pSS. A thorough history and clinical examination, antibody testing, brain MRI imaging and/or MRS of the cerebellum will assist in establishing the diagnosis. Setting up a joint neuro-rheumatology clinic can be valuable given that rheumatic and neurological diseases share comorbidities.
Topics: Adult; Cerebellar Ataxia; Cerebellar Diseases; Child; Female; Humans; Inflammation; Magnetic Resonance Imaging; Male; Sjogren's Syndrome
PubMed: 34611842
DOI: 10.1007/s13760-021-01784-1