{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:25:42Z","timestamp":1793125542706,"version":"4.5.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Primary Sj\u00f6gren\u2019s Syndrome (PSS) is a chronic disease characterised by symptoms of oral and ocular dryness, pain, fatigue, anxiety and depression. PSS patients can be subclassified by the pattern of severity of these five key symptoms using the Newcastle Sj\u00f6gren\u2019s Stratification Tool (NSST). Although PSS is often associated with one or more comorbidities, the relationship between comorbidities, polypharmacy, and PSS symptom burden is unclear. Using data from the UK Primary Sj\u00f6gren\u2019s Syndrome Registry (UKPSSR) we describe the landscape of polypharmacy and comorbidities in PSS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The UKPSSR is research biobank of clinically well-defined PSS patients where clinical, demographic, comorbidities and concomitant medications data are recorded. Patients were subclassified into the four NSST subgroups: Low Symptom Burden (LSB), High Symptom Burden (HSB), Dryness Dominated Fatigue (DDF) and Pain Dominated Fatigue (PDF). Group analyses of comorbid conditions and polypharmacy scores were performed. Comorbidity and Polypharmacy Scores (CPS) were modelled as a function of age, sex, symptom duration, body mass index (BMI), current immunosuppressant and hydroxychloroquine prescriptions and NSST subgroup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were marked differences in the number and the nature of comorbidities associated with the NSST subgroups. LSB and DDF patients were characterized by fewer comorbidities and medications. In contrast, HSB and PDF patients were associated with more comorbidities and were more likely to be prescribed multiple medications. Group analysis shows that HSB patients are more closely associated with peripheral vascular disease and infection whereas the PDF patients were associated with cardiovascular disease and gastrointestinal comorbidities. Comorbidity and polypharmacy scores increase with age and BMI regardless of symptom subgroup and symptom duration. In addition, the longer the reported symptom duration the higher the associated comorbidities and polypharmacy scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Comorbid conditions are more prevalent in some subgroups of the PSS cohort but increase with age and BMI across the entire cohort. It is unclear from these data whether specific comorbid conditions are a consequence of PSS or represent shared aetiology or pathogenetic susceptibility. Regardless, these findings may have implications for disease management and clinical trial design.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.864448","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T13:19:13Z","timestamp":1650633553000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Comorbidities in the UK Primary Sj\u00f6gren\u2019s Syndrome Registry"],"prefix":"10.3389","volume":"13","author":[{"given":"Jessica","family":"Tarn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Lendrem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Barnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Casement","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan-Fai","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13451","article-title":"Primary Sj\u00f6gren\u2019s Syndrome: Longitudinal Real-World, Observational Data on Health-Related Quality of Life","author":"Tarn","year":"2022","journal-title":"J Intern Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S47399","article-title":"The Epidemiology of Sj\u00f6gren\u2019s Syndrome","volume":"6","author":"Patel","year":"2014","journal-title":"Clin Epidemiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1007\/978-1-60327-957-4_17","article-title":"Extraglandular Manifestations of Sj\u00f6gren\u2019s Syndrome (SS): Dermatologic, Arthritic, Endocrine, Pulmonary, Cardiovascular, Gastroenterology, Renal, Urology, and Gynecologic Manifestations","author":"Fox","year":"2011","journal-title":"Sj\u00f6gren\u2019s Syndrome"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key329","article-title":"Comorbidities (Excluding Lymphoma) in Sj\u00f6gren\u2019s Syndrome","volume":"60","author":"Pego-Reigosa","year":"2021","journal-title":"Rheumatol (Oxford)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1136\/lupus-2021-000526","article-title":"Comorbidity and Health Care Utilisation in Persons With Sj\u00f6gren\u2019s Syndrome: A Claims Data Analysis","volume":"38","author":"Albrecht","year":"2020","journal-title":"Clin Exp Rheumatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090942","article-title":"Comorbidities in Patients With Primary Sj\u00f6gren\u2019s Syndrome: A Registry-Based Case-Control Study","volume":"37","author":"Kang","year":"2010","journal-title":"J Rheumatol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1186\/s40064-015-1557-7","article-title":"Gastrointestinal Disease in Sjogren\u2019s Syndrome: Related to Food Hypersensitivities","volume":"4","author":"Kim-Lee","year":"2015","journal-title":"Springerplus"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12346","article-title":"Cardiovascular Disease Risk Burden in Primary Sj\u00f6gren\u2019s Syndrome: Results of a Population-Based Multicentre Cohort Study","volume":"278","author":"Bartoloni","year":"2015","journal-title":"J Intern Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22227","article-title":"Cardiovascular Risk Factors in Women With Primary Sj\u00f6gren\u2019s Syndrome: United Kingdom Primary Sj\u00f6gren\u2019s Syndrome Registry Results","volume":"66","author":"Juarez","year":"2014","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2174\/1574887113666180315130336","article-title":"Cardiovascular Disease in Primary Sj\u00f6gren\u2019s Syndrome","volume":"13","author":"Berardicurti","year":"2018","journal-title":"Rev Recent Clin Trials"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(19)30042-6","article-title":"Symptom-Based Stratification of Patients With Primary Sj\u00f6gren\u2019s Syndrome: Multi-Dimensional Characterisation of International Observational Cohorts and Reanalyses of Randomised Clinical Trials","volume":"1","author":"Tarn","year":"2019","journal-title":"Lancet Rheumatol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq240","article-title":"United Kingdom Primary Sjogren\u2019s Syndrome Registry\u2013a United Effort to Tackle an Orphan Rheumatic Disease","volume":"50","author":"Ng","year":"2011","journal-title":"Rheumatol (Oxford)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.554","article-title":"Classification Criteria for Sj\u00f6gren\u2019s Syndrome: A Revised Version of the European Criteria Proposed by the American-European Consensus Group","volume":"61","author":"Vitali","year":"2002","journal-title":"Ann Rheum Dis"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2014-000022","article-title":"EULAR Sjogren\u2019s Syndrome Disease Activity Index (ESSDAI): A User Guide","volume":"1","author":"Seror","year":"2015","journal-title":"RMD Open"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.143743","article-title":"EULAR Sjogren\u2019s Syndrome Patient Reported Index (ESSPRI): Development of a Consensus Patient Index for Primary Sjogren\u2019s Syndrome","volume":"70","author":"Seror","year":"2011","journal-title":"Ann Rheum Dis"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The Hospital Anxiety and Depression Scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken426","article-title":"Patient-Reported Outcomes in Primary Sjogren\u2019s Syndrome: Comparison of the Long and Short Versions of the Profile of Fatigue and Discomfort\u2013Sicca Symptoms Inventory","volume":"48","author":"Bowman","year":"2009","journal-title":"Rheumatol (Oxford)"},{"key":"B18","volume-title":"R: A Language and Environment for Statistical Computing","year":"2021"},{"key":"B19","first-page":"1989","volume-title":"JMP\u00ae, Version 15","year":"2021"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.14227","article-title":"Asymptomatic Myocardial Dysfunction was Revealed by Feature Tracking Cardiac Magnetic Resonance Imaging in Patients With Primary Sj\u00f6gren\u2019s Syndrome","volume":"24","author":"Yokoe","year":"2021","journal-title":"Int J Rheum Dis"},{"key":"B21","doi-asserted-by":"publisher","first-page":"E3469","DOI":"10.3390\/jcm9113469","article-title":"Cardiovascular Protection of Hydroxychloroquine in Patients With Sj\u00f6gren\u2019s Syndrome","volume":"9","author":"Yang","year":"2020","journal-title":"J Clin Med"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.864448\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T12:54:35Z","timestamp":1651668875000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.864448\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,22]]},"references-count":21,"alternative-id":["10.3389\/fimmu.2022.864448"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2022.864448","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,22]]},"article-number":"864448"}}