Abstract：
10% of rheumatoid arthritis (RA) cases are associated to so-called secondary Sjögren\'s syndrome (SS). These RA cases have higher DAS, fewer remissions. Is this linked to a poor response to DMARDs (disease-modifying anti-rheumatic drugs)? No study has addressed this question to date. Does the association between secondary Sjögren\'s syndrome (SS) and rheumatoid arthritis (RA) affect the therapeutic response to DMARDs and long-term prognosis? We conducted a retrospective case-control study: 39 RA associated with SS was (anti-SSA antibodies and/or Chisolm stage III or IV) were compared to 39 isolated cases of erosive RA matched by age, duration of progression and gender. The DAS CRP was higher in the RA + SS group in patients with disease progression of 16 years: 2.6 (1.5-4.5) compared to the RA group: 1.6 (1.3-2.8) (p = 0.0001) while fewer patients were in remission: 61 vs. 92% (p = 0.002). A higher number of B DMARDs have been prescribed: RA + SS = 3.04 (1-7); RA = 1.7 (1-5) (p = 0.004). Anti-TNFs are less effective when RA is associated with SS: 30 vs. 70%. Conversely, Rituximab is more effective when RA is associated with SS: 80 vs. 30%. Erosive RA-related SS exacerbates the clinical course of the condition: higher DAS, fewer remissions. This is linked to reduced treatment efficacy: higher number of DMARDs prescribed, reduced efficacy of anti-TNF drugs. RA-related SS could modify sensitivity to biotherapies: lower percentage of remissions and resistance to anti-TNF drugs.
摘要：
10％的类风湿性关节炎（RA）病例与所谓的继发性干燥综合征（SS）有关。这些RA病例有较高的DAS,更少的减免。这是否与对DMARDs（改善疾病的抗风湿药物）的反应不佳有关？迄今为止，尚无研究解决此问题。继发性干燥综合征（SS）和类风湿关节炎（RA）之间的关联是否会影响DMARDs的治疗反应和长期预后？我们进行了一项回顾性病例对照研究：将39例与SS相关的RA（抗SSA抗体和/或ChisolmIII或IV期）与39例按年龄匹配的糜烂性RA病例进行了比较，进展持续时间和性别。与RA组：1.6（1.3-2.8）（p=0.0001）相比，疾病进展为16年的RASS组的DASCRP较高：2.6（1.5-4.5），而缓解的患者较少：61vs.92%(p=0.002)。已经规定了更多数量的BDMARD:RA+SS=3.04(1-7);RA=1.7(1-5)(p=0.004)。当RA与SS：30和70%。相反，当RA与SS相关时，利妥昔单抗更有效：80vs.30%。腐蚀性RA相关的SS加剧了病情的临床过程：较高的DAS，更少的减免。这与治疗效果降低有关：规定的DMARDs数量增加，降低了抗TNF药物的疗效。与RA相关的SS可以改变对生物治疗的敏感性：降低缓解率和对抗TNF药物的抗性。
