ORIGINAL RESEARCH article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1639252
Impact of Sjögren's disease and its immunological characteristics on reaching remission or low disease activity state in systemic lupus erythematosus patients: a propensity-score matched longitudinal study
Provisionally accepted
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Bejing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background Systemic lupus erythematosus (SLE) overlapping with Sjögren's disease (SjD) or not may progress differently in clinical course. We aimed to explore the impact of SjD on Lupus Low Disease Activity State (LLDAS) or remission achievement in a real-world cohort. Methods We retrospectively reviewed the medical records of patients in the Peking University First Hospital SLE (PKUFHS) cohort from 2007 to 2019. Demographics, SLE and SjD features, treatment, in LLDAS/remission on treatment (RONT) or not at each visit were collected. According to overlapped SjD and its immunological features, all patients were identified as following subgroups, SjD with anti-SSA-single-positivity, SjD with anti-SSA/SSB-double-positivity, SjD with baseline hypergammaglobulinemia, and those without SjD. Cox proportional hazard model in propensity-score matched cohorts was used to estimate the impact of different SjD characteristics on LLDAS/RONT and each component after correcting known confounders. Results 9415 visits originating from 626 SLE patients were included. Overlapping SjD was identified in 77 (12.3%) patients. Patients with SLE overlapping SjD were significantly older at onset, female dominant with more frequent hematological involvement. Overlapping SjD and anti-SSA/SSB-double-positive SjD were associated with 29%~38% and 50%~53% reduction in RONT achievement in SLE patients. While both overlapping SjD and SjD with baseline hypergammaglobulinemia acted as protectors for LLDAS achievement with 24% and 31% increment, and anti-SSA-single-positive SjD showed no definite effect. The most affected target component was normal serology, where hazard ratios of 0.64~0.85 for overlapping SjD and anti-SSA/SSB-double-positive SjD, 1.15~1.24 for SjD with baseline
Keywords: systemic lupus erythematosus, remission on treatment, lupus low disease activity state, Overlapping syndrome, Sjogren' s disease
Received: 01 Jun 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Zhang, Zhang, Gao, Ji, Hao and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhuoli Zhang, Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Bejing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.