Subjective and Objective Measures of Dryness Symptoms in Primary Sjögren's Syndrome - Capturing the discrepancy

Oriana M Bezzina, Peter Gallagher, Sheryl Mitchell, Simon J Bowman, Bridget Griffiths, Victoria Hindmarsh, Ben Hargreaves, Elizabeth J Price, Colin T Pease, Paul Emery, Peter Lanyon, Michele Bombardieri, Nurhan Sutcliffe, Costantino Pitzalis, John Hunter, Monica Gupta, John McLaren, Anne M Cooper, Marian Regan, Ian P GilesDavid A Isenberg, Saravanan Vadivelu, David Coady, Bhaskar Dasgupta, Neil J McHugh, Steven A Young-Min, Robert J Moots, Nagui Gendi, Mohammed Akil, Kirsten MacKay, W Fai Ng, Lucy J Robinson, UK Primary Sjögren's Syndrome Registry

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21 Citations (SciVal)


BACKGROUND: There is a weak relationship between subjective symptoms and objective markers of disease activity in individuals with Primary Sjögren's Syndrome (PSS). This presents a significant barrier to developing treatments if modifying disease markers does not translate into reduced perception of symptoms. Little is known about the reasons for this discrepancy.

OBJECTIVES: To develop a novel method for capturing the discrepancy between objective tests and subjective dryness symptoms (a 'Sensitivity' scale) and to explore predictors of dryness Sensitivity.

METHODS: Archive data from the UK Primary Sjogren's Syndrome Registry (n=681) was used. Patients were classified on a scale from -5 (stoical) to +5 (sensitive) depending on the degree of discrepancy between their objective and subjective symptoms classes. Sensitivity scores were correlated with demographic variables, disease-related factors and symptoms of pain, fatigue, anxiety and depression.

RESULTS: Patients were on average relatively stoical for both dryness symptoms (ocular mean±s.d. -0.42±2.2, oral mean±s.d. -1.24±1.6). Twenty-seven percent of patients were classified 'sensitive' to ocular dryness in contrast to 9% for oral dryness. Hierarchical regression analyses identified the strongest predictor of ocular dryness was self-reported pain and the strongest predictor of oral dryness was self-reported fatigue.

CONCLUSIONS: Ocular and oral dryness sensitivity can be classified on a continuous scale. The two symptom types are predicted by different variables. A large number of factors remain to be explored that may impact on symptom-sensitivity in PSS and the proposed method could be used to identify relatively sensitive and stoical patients for future studies. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalArthritis Care and Research
Publication statusPublished - 19 Dec 2016


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