A north-south worldwide gradient in systemic activity of primary sjÖgren syndrome: increased severe disease in patients from southern countries
S. Retamozo1,2,3, N. Acar-Denizli4, W. Fai Ng5, M. Zeher6, A. Rasmussen7, R. Seror8, X. Li9, C. Baldini10, J.-E. Gottenberg11, D. Danda12, L. Quartuccio13, R. Priori14, G. Hernandez-Molina15, B. Armagan16, A.A. Kruize17, S.-K. Kwok18, M. Wahren-Herlenius19, S. Praprotnik20, D. Sene21, E. Bartoloni22, R. Solans23, M. Rischmueller24, T. Mandl25, Y. Suzuki26, D. Isenberg27, V. Valim28, P. Wiland29, G. Nordmark30, G. Fraile31, H. Bootsma32, T. Nakamura33, R. Giacomelli34, V. Devauchelle-Pensec35, B. Hofauer36, M. Bombardieri37, V. Fernandes Moça Trevisani38, D. Hammenfors39, S.G. Pasoto40, T.A. Gheita41, F. Atzeni42, J. Morel43, C. Vollenveider44, P. Brito-Zerón1,45, M. Ramos-Casals1, on behalf of the Sjogren Big Data Consortium
1H. Clinic, IDIBAPS, Barcelona, Spain 2Hosp Privado Córdoba, IUCBC 3INICSA, UNC, CONICET, Cordoba, Argentina 4Mimar Sinan Univ, Istanbul, Turkey 5Newcastle Univ, NHS Foundation Trust, Newcastle, UK 6Debrecen Univ, Debrecen, Hungary 7Oklahoma Medical Research Foundation, Oklahoma, USA 8Université Paris Sud, INSERM, Paris, France 9Anhui Provincial Hosp, Hefei, China 10Pisa Univ, Pisa, Italy 11Strasbourg Univ, CNRS, Strasbourg, France 12Christian Medical College and Hosp, Vellore, India 13Hosp “Santa Maria della Misericordia”, Udine 14Sapienza Univ, Rome, Italy 15INCMNSS, Mexico, Mexico 16Hacettepe Univ, Ankara, Turkey 17Univ Medical Center, Utrecht, Netherlands 18Catholic Univ of Korea, Seoul, Korea, Republic Of 19Karolinska Institute, Stockholm, Sweden 20Univ Medical Centre, Ljubljana, Slovenia 21Univ Paris VII Publique-Hôpitaux de Paris, 2, Paris, France 22Perugia Univ, Perugia, Italy 23H. Vall d’Hebron, Barcelona, Spain 24Western Australia Univ, Crawley, Australia 25Malmö Hosp, Lund Univ, Lund, Sweden 26Kanazawa Univ Hosp, Ishikawa, Japan 27University College, London, UK 28Federal Univ Espírito Santo, Vitória, Brazil 29Wroclaw Medical Hospital, Wroclaw, Poland 30Uppsala Univ, Uppsala, Sweden 31H. Ramón y Cajal, Madrid, Spain 32Univ Medical Center, Groningen, Netherlands 33Nagasaki University, Nagasaki, Japan 34L’Aquila Univ, L’Aquila, Italy 35Brest Univ Hosp, CERAINO, Brest, France 36Technische Univ, Mu&x00EE;nchen, Germany 37Queen Mary Univ, London, UK 38Federal University of São Paulo, Sao Paulo, Brazil 39Haukeland Univ Hosp, Bergen, Norway 40Hospital das Clínicas, USP, São Paulo, Brazil 41Cairo University, Cairo, Egypt 42Messina and Milan Univ, Milan, Italy 43Hosp and Univ of Montpellier, Montpellier, France 44German Hosp, Buenos Aires, Argentina 45H. CIMA- Sanitas, Barcelona, Spain
Objectives: To analyse the influence of geolocation on the clinical systemic presentation of primary Sjögren syndrome (SjS) at diagnosis.
Methods: The Big Data Sjögren Project Consortium is an international, multicentre registry created in 2014. Centres were classified by continent, with an additional north-south sub-classification according to latitude (>or<50’N in Europe, equator >or <in America and>or<30’N in Asia). Systemic involvement at diagnosis was retrospectively scored using the ESSDAI.
Results: The highest baseline ESSDAI scores were reported from Southern vs Northern countries in Europe (7.2 vs 4.6, p<0.001), America (5.3 vs 3.5, p<0.001) and Asia (6.3 vs 3.9, p<0.001). In Europe, the frequency of activity in each domain was higher in Southern countries (in all domains except constitutional, p<0.001). In America, Southern countries had the highest frequencies of active patients in constitutional, articular, cutaneous, pulmonary, PNS and CNS domains (p<0.001 in all) and the lowest frequencies in lymphadenopathy (p=0.018) and biological (p<0.001) domains. In Asia, patients from China had the highest frequency of activity in glandular, articular, pulmonary, muscular, haematological and biological and those from India in lymphadenopathy, cutaneous, renal and PNS.
Conclusions: This study provides the first evidence for a strong influence of geolocation on the systemic phenotype of primary SjS at diagnosis. Geographical determinants should be considered as key variables when systemic disease is scored.
Disclosure of Interest: None declared
DOI: 10.1136/annrheumdis-2018-eular.6446
Citation: Ann Rheum Dis, volume 77, supplement Suppl, year 2018, page A1190
Session: Epidemiology, risk factors for disease or disease progression
