Background/Purpose: Examine the racial and ethnic make-up of a large cohort of Sjögren’s syndrome (SS) gathered in the USA compared to the make-up found among SLE patients, as well as the clinical manifestations of SS in Black- and Hispanic-Americans.

Methods: Consecutive subjects, all of whom had dry eyes and mouth, attending a comprehensive sicca evaluation clinic underwent dental, ophthalmological and medical examinations. Subjects were classified according to the American-European Consensus Group Criteria (AECG) as well as the SICCA/ACR criteria. Furthermore, race and ethnicity were recorded based on self-report as well as NIH-defined race and ethnicity.  Laboratory and serological studies included determination of anti-Ro/La by multiple methods.

Results: Among 256 subjects classified as primary Sjögren’s syndrome, 9 (3.5%) were African-Americans and 9 (3.5%) were Hispanic-Americans.  This was substantially below the representation of these minorities in the general population of the region (about 10% each), but was no different than that found among 273 subjects not classified as SS who had no anti-Ro/La and a focus score of 0.0.  Compared to 152 non-Hispanic white Americans classified as SS, the blacks Americans with SS were less likely to have an abnormal Schirmer’s test (1 of 9 versus 79 of 152, Fisher’s p=0.03).  Other clinical manifestations were similar between non-Hispanic whites and Blacks- or Hispanic Americans.  Both Hispanic and black SS subjects were more likely to have anti-Ro (or SSA) than non-Hispanic white SS, and black SS were also more likely to have anti-La (or SSB) (6 of 9 versus 44 of 152, Fisher’s p=0.026).  We also compared the race and ethnicity of the SS cohort to a cohort of SLE patients collected in the same geographic area.  Of 477 SLE patients, 106 were black.  This was statistically different compared to SS (9 of 152 versus 106 of 447, χ2=42.7, p>0.001, odds ratio=7.8 (95%CI=3.9-15.8)).  There were 32 Hispanics among the SLE group, and this difference almost reached statistical significance (χ2=3.27, p=0.07, OR=0.99-4.6).

Conclusion: Neither Black-Americans nor Hispanic-Americans were commonly found among a cohort with Sjögren’s syndrome.  Further, SS was not more severe in either Blacks or Hispanics. This is in contrast to SLE, where both these minority groups were over-represented among SLE, and disease is more severe.  These findings may well represent a biological difference between Sjögren’s and SLE, but socioeconomic factors impacting upon access to care and referral could be important.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/sjogrens-syndrome-in-american-ethnic-and-racial-minorities/