• Chia-Chun Tseng, Shun-Jen Chang, Wen-Chan Tsai, Tsan-Teng Ou, Cheng-Chin Wu, Wan-Yu Sung, Ming-Chia Hsieh, and Jeng-Hsien Yen.
• Department of Internal Medicine (Tseng), Kaohsiung Municipal Ta-Tung Hospital; Department of Kinesiology (Chang), Health and Leisure Studies, National University of Kaohsiung; Division of Rheumatology (Tsai, Ou, Wu, Sung, Yen), Department of Internal Medicine, Kaohsiung Medical University Hospital; Graduate Institute of Medicine (Sung, Yen), College of Medicine, Kaohsiung Medical University; Division of Endocrinology and Metabolism, Department of Internal Medicine (Hsieh), Changhua Christian Hospital, Changhua, Taiwan; Graduate Institute of Integrated Medicine (Hsieh), China Medical University, Taichung, Taiwan.
• CMAJ. 2017 Feb 6; 189 (5): E187-E193.

BackgroundAlthough dermatomyositis and Sjögren syndrome share serologic autoantibodies and genetic polymorphisms, population data about the incidence of Sjögren syndrome in patients with dermatomyositis is unavailable. We performed a nationwide cohort study to explore the potential relation between dermatomyositis and Sjögren syndrome and, if an association exists, to elucidate whether it varies by sex.MethodsWe identified all patients with newly diagnosed dermatomyositis from the Registry of Catastrophic Illness Database in Taiwan between Jan. 1, 1998, and Dec. 31, 2011. Each patient was matched to, at most, 5 control patients from the National Health Insurance Research Database by age, sex and entry date. Cox regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of Sjögren syndrome after adjusting for age, sex, rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis.ResultsA total of 1602 patients with dermatomyositis and 7981 control patients were enrolled in the study. There was a positive association of having Sjögren syndrome among patients with dermatomyositis after adjusting for age, sex, rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis (HR 2.67, 95% CI 2.01-3.54). The association was more pronounced in the male cohort (HR 2.69, 95% CI 1.19-6.09).InterpretationWe found a sex differential association of Sjögren syndrome among patients with dermatomyositis independent of age and concomitant autoimmune disease. Further studies are required to determine the clinical importance of this association for both outcomes and therapeutic options.© 2017 Canadian Medical Association or its licensors.

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