{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T16:53:36Z","timestamp":1757609616736,"version":"3.44.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This study aimed to evaluate clinical and serological factors influencing systemic disease activity in primary Sj\u00f6gren\u2019s disease (SjD) using the European League Against Rheumatism Sj\u00f6gren\u2019s Syndrome Disease Activity Index (ESSDAI) and to identify distinct patient subgroups in a Japanese cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from 7444 patients with ESSDAI \u22655 registered in Japan\u2019s National Database of Designated Intractable Diseases were analysed. Univariate and multivariate regression analyses evaluated the impact of demographic and serological factors on ESSDAI scores. K-means clustering identified subgroups based on significant variables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Male patients exhibited higher ESSDAI scores (coefficient: 0.76, P\u2009=\u2009.0007), whereas Hashimoto\u2019s disease was associated with lower scores (coefficient: \u22120.53, P\u2009=\u2009.009). Anti-SS-B\/La (coefficient: 1.08, P\u2009=\u2009.0002) and high titre of antinuclear antibody (ANA) (coefficient: 0.64, P\u2009=\u2009.02) were associated with increased ESSDAI. Clustering identified three subgroups: a \u2018classic\u2019 SjD group with balanced systemic involvement, a male-specific group with severe manifestations, and a Hashimoto\u2019s disease group with milder activity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Primary SjD in Japan exhibits significant heterogeneity influenced by demographic and serological factors. Male sex and specific autoantibodies correlate with higher systemic activity, whereas Hashimoto\u2019s disease is associated with reduced severity. These findings elucidate the need for personalised management and longitudinal studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/mr\/roaf027","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T11:10:39Z","timestamp":1741950639000},"page":"859-865","source":"Crossref","is-referenced-by-count":0,"title":["Nationwide epidemiological survey of primary Sjogren\u2019s disease in Japan using the National Database of Designated Intractable Diseases"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5904-687X","authenticated-orcid":false,"given":"Yuzaburo","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of General Medical Science, Graduate School of Medicine, Chiba University , Chiba,","place":["Japan"]},{"name":"Department of Paediatrics, Eastern Chiba Medical Centre , Chiba,","place":["Japan"]},{"name":"Department of Allergy and Rheumatology, Chiba Children\u2019s Hospital , Chiba,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoko","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Meiji Pharmaceutical University , Kiyose, Tokyo,","place":["Japan"]},{"name":"Department of Rheumatology, Tokyo Women\u2019s Medical University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eisuke","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tokyo Women\u2019s Medical University School of Medicine , Tokyo,","place":["Japan"]},{"name":"Showa University Research Administration Centre, Showa University , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanako","family":"Mitsunaga","sequence":"additional","affiliation":[{"name":"Department of Allergy and Rheumatology, Chiba Children\u2019s Hospital , Chiba,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Yamaji","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaaki","family":"Mori","sequence":"additional","affiliation":[{"name":"Joint Research Department of Lifelong Immunotherapy, Institute of Science Tokyo , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minako","family":"Tomiita","sequence":"additional","affiliation":[{"name":"Department of Allergy and Rheumatology, Chiba Children\u2019s Hospital , Chiba,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Shimojo","sequence":"additional","affiliation":[{"name":"Centre for Preventive Medical Sciences, Chiba University , Chiba,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takako","family":"Miyamae","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tokyo Women\u2019s Medical University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"2025090306271680900_R1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.clim.2019.04.009","article-title":"Sjogren\u2019s syndrome: an update on disease pathogenesis, clinical manifestations and treatment","volume":"203","author":"Vivino","year":"2019","journal-title":"Clin Immunol"},{"key":"2025090306271680900_R2","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1136\/ard.2009.110619","article-title":"EULAR Sjogren\u2019s syndrome disease activity index: development of a consensus systemic disease activity index for primary Sjogren\u2019s 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