ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1482

Preliminary Population-Based Incidence and Prevalence Estimates of Primary Sjogren’s Syndrome from the Manhattan Lupus Surveillance Program

Peter M. Izmirly1, Isabella Wan2, Sara Sahl3, Jill P. Buyon4, H. Michael Belmont5, Jane E. Salmon6, Anca Askanase7, Joan Bathon8, Laura Geraldino-Pardilla7, Yousaf Ali9, Ellen M. Ginzler10, Chaim Putterman11, Caroline Gordon12, Charles G. Helmick13 and Hilary Parton14, 1Medicine, Division of Rheumatology, New York University School of Medicine, New York, NY, 2Medicine/Rheumatology, New York University School of Medicine, New York, NY, 3Pediatrics, Harbor-University of California at Los Angeles Medical Center, Torrance, CA, 4Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, NY, 5Medicine, New York University School of Medicine, New York, NY, 6Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY, 7Rheumatology, Columbia University College of Physicians & Surgeons, New York, NY, 8Division of Rheumatology, Columbia University, College of Physicians & Surgeons, New York, NY, 9Medicine/Rheumatology, Icahn School of Medicine at Mount Sinai, New York, NY, 10Rheumatology, Division of Rheumatology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, 11Division of Rheumatology, Albert Einstein College of Medicine, Bronx, NY, USA, Bronx, NY, 12Rheumatology Research Group, Institute of Inflammation and Ageing,, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom, 13Centers for Disease Control and Prevention, Atlanta, GA, 14Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, Long Island City, NY

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ,

Session Information

Date: Monday, November 6, 2017

Title: Sjögren's Syndrome Poster II: Clinical Research

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: The extant epidemiologic data of Primary Sjögren’s Syndrome (pSS) remains limited with few published estimates for the general population and little data regarding racial/ethnic populations in the U.S. The Manhattan Lupus Surveillance Program (MLSP) is a population-based registry comprised of patients with Systemic Lupus Erythematosus (SLE) and related diseases including pSS treated in New York County (Manhattan) that was developed to determine the incidence and prevalence of SLE among Manhattan residents. Leveraging MLSP data we provide estimates of the prevalence and incidence of pSS during 2007 and 2007-09, respectively, in Manhattan across the major racial/ethnic populations (black, Hispanic, Asian, white).

Methods: MLSP cases were identified from hospitals, rheumatologists, and state population databases. Case screening was performed using ICD-9 codes, including 710.2 for SS. Charts were abstracted and final diagnosis was coded for Manhattan residents with one of the screening ICD-9 codes. pSS was defined using three case definitions: 1) a physician (regardless of specialty for cases hospitalized and not seen by a Rheumatologist) stating the diagnosis of pSS; 2) a rheumatologist’s diagnosis of pSS 3) a diagnosis of pSS with documentation of patient complaints of dry eyes and/or dry mouth and autoantibodies defined as a positive anti-SSA and/or anti-SSB antibody or a positive rheumatoid factor and antinuclear antibody titer >1:320.

Results: Based on the diagnosis of pSS found in the medical chart, the preliminary age-adjusted overall prevalence and incidence rates of pSS in Manhattan were 9.8 and 2.6 per 100,000, respectively, Table 1. The overall prevalence and incidence rates were 6 times higher among women than men, and rates among women were also higher within racial/ethnic groups. The prevalence of pSS was 17.4 among Asian women, 17.2 among white women 10.2 among Hispanic women, and 8.5 among black women, though confidence intervals overlapped, Table 1. The incidence of pSS was 7.1 among Asian women, 4.2 among white women, 2.2 among black women, and 2.0 among Hispanic women. Restricting the case definition to a rheumatologist diagnosis or to cases with symptoms and autoantibodies reduced both the prevalence and incidence of pSS, though there were similar trends in gender and racial/ethnic differences, Table 1. The average age ±SD at diagnosis among incident cases was 52.4 ±18.4 years among women and 58.1 ±17.3 years among men. The average age ±SD at diagnosis among incident cases was 48.6 ±18.2 years among Asians, 55.0 ±19.2 years among whites, 48.0 ±12.5 years among blacks, and 57.3 ±19.7 years among Hispanics.

Conclusion: Using data from a large population-based registry revealed substantial gender disparities in pSS among Manhattan residents. These data also provided epidemiologic estimates for the major racial/ethnic populations in the U.S.

Table 1: Age-adjusted rates of Sjogren’s Syndrome among Manhattan residents, overall and by sex and race/ethnicity

Prevalent Cases, 2007

Rate per 100,000
(95% Confidence Interval)

Incident cases, 2007-2009

Rate per 100,000
(95% Confidence Interval)

Primary Sjogren’s

Total

9.8 (8.3-11.3)

2.6 (2.2 -3.1)

Male

2.6 (1.5 -4.0)

0.7 (0.4 -1.1)

Female

15.8 (13.2-18.4 )

4.2(3.5- 5.0)

Race/ethnicity

Non-Hispanic White

10.5 (8.4-13.0)

2.6 (2.0-3.3)

Male

3.0 (1.5-5.2)

0.8 (0.4-1.4)

Female

17.2 (13.4-21.7)

4.2 (3.2-5.6)

Non-Hispanic Black

5.2 (2.7 -9.1)

1.5 (0.7-2.8)

Male

1.3 (0.0-7.0)

0.7 (0.1-2.4)

Female

8.5 (4.2 -15.3)

2.2 (0.9-4.4)

Hispanic

6.2 (4.0-9.2)

1.3 (0.8-2.2)

Male

1.1 (0.1-4.0)

0.4 (0.0-1.3)

Female

10.2 (6.4-15.3)

2.0 (1.1-3.5)

Non-Hispanic Asian

9.8 (5.7-15.7)

4.2 (2.6-6.3)

Male

0.0

0.5 (0.0 -2.7)

Female

17.4 (10.2-27.7)

7.1 (4.4 -10.8)

Primary Sjogren’s with Rheumatologist Diagnosis

Total

5.5 (4.4 -6.7)

1.6 (1.3-2.0)

Male

1.4 (0.6 -2.5)

0.3 (0.2-0.7)

Female

9.0 (7.1 -11.1)

2.6 (2.0-3.3)

Race/ethnicity

Non-Hispanic White

5.4 (3.9 -7.4)

1.7 (1.2-2.3)

Male

1.5 (0.6 -3.4)

0.3 (0.1-0.8)

Female

8.8 (6.1 -12.4)

2.8 (1.9 -3.9)

Non-Hispanic Black

2.7 (1.0 -5.9)

0.9 (0.3 -2.0)

Male

0.0

0.7 (0.1-2.4)

Female

5.0 (1.8-10.9)

1.2 (0.3 -3.0)

Hispanic

3.7 (2.0-6.1)

0.5 (0.2-1.1)

Male

0.6 (0.0-3.2)

0.0

Female

6.1 (3.3 -10.2)

1.0 (0.4 -2.0)

Non-Hispanic Asian

6.4 (3.3-11.3)

2.6 (1.5 -4.4)

Male

0.0

0.5 (0.0-2.7)

Female

11.4 (5.9-20.1)

4.3 (2.3-7.3)

Primary Sjogren’s modified definition

Total

2.6 (1.9-3.5)

0.9 (0.6 -1.2)

Male

0.5 (0.1 -1.3)

0.2 (0.0-0.4)

Female

4.5 (3.2-6.0)

1.5 (1.1 -2.0)

Race/ethnicity

Non-Hispanic White

2.0 (1.2 -3.2)

0.6 (0.4 -1.0)

Male

0.5 (0.1-1.8)

0.1 (0.0-0.4)

Female

3.4 (1.9-5.6)

1.1 (0.6-1.7)

Non-Hispanic Black

1.7 (0.5-4.4)

0.6 (0.2-1.5)

Male

0.0

0.7 (0.1-2.4)

Female

3.1 (0.8-8.1)

0.5 (0.1-2.0)

Hispanic

2.0 (0.9 -3.9)

0.5 (0.2-1.0)

Male

0.0

0.0

Female

3.8 (1.7-7.2)

0.8 (0.3-1.8)

Non-Hispanic Asian

4.5 (2.0-8.8)

2.1 (1.1 -3.6)

Male

0.0

0.5 (0.0 -2.7)

Female

8.1 (3.5-15.8)

3.3 (1.6 -6.0)

Rates are per 100,000 Manhattan residents. Denominator data is based on 2007 intercensal population estimates from the NYC DOHMH Bureau of Epi Services (2000-2014 files).

Data are age adjusted to the US 2000 Standard Population.

Cases were assigned to one of five mutually exclusive race/ethnicity categories: non-Hispanic white, non-Hispanic black, non-Hispanic Asian, Hispanic, and non-Hispanic other. Non-Hispanic cases identified with more than one race were categorized as non-Hispanic other.

Disclosure: P. M. Izmirly, None; I. Wan, None; S. Sahl, None; J. P. Buyon, Exagen, 2; H. M. Belmont, None; J. E. Salmon, None; A. Askanase, None; J. Bathon, None; L. Geraldino-Pardilla, None; Y. Ali, None; E. M. Ginzler, None; C. Putterman, None; C. Gordon, None; C. G. Helmick, None; H. Parton, None.

To cite this abstract in AMA style:

Izmirly PM, Wan I, Sahl S, Buyon JP, Belmont HM, Salmon JE, Askanase A, Bathon J, Geraldino-Pardilla L, Ali Y, Ginzler EM, Putterman C, Gordon C, Helmick CG, Parton H. Preliminary Population-Based Incidence and Prevalence Estimates of Primary Sjogren’s Syndrome from the Manhattan Lupus Surveillance Program [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/preliminary-population-based-incidence-and-prevalence-estimates-of-primary-sjogrens-syndrome-from-the-manhattan-lupus-surveillance-program/. Accessed .

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