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Comorbidity and health care utilisation in persons with Sjögren’s syndrome: a claims data analysis


1, 2, 3, 4, 5, 6, 7

 

  1. German Rheumatism Research Centre, Epidemiology Unit, Berlin, Germany. albrecht@drfz.de
  2. German Rheumatism Research Centre, Epidemiology Unit, Berlin, and Charité University Medicine Berlin, Germany.
  3. German Rheumatism Research Centre, Epidemiology Unit, Berlin, Germany.
  4. Practice for Rheumatology and Internal Medicine, Berlin, Germany.
  5. BARMER Statutory Health Insurance Fund, Wuppertal, Germany.
  6. German Rheumatism Research Centre, Epidemiology Unit, Berlin, and Charité University Medicine Berlin, Germany.
  7. German Rheumatism Research Centre, Epidemiology Unit, Berlin, Germany.

CER13672
2020 Vol.38, N°4 ,Suppl.126
PI 0078, PF 0084
Clinical aspects

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PMID: 33025885 [PubMed]

Received: 08/06/2020
Accepted : 29/07/2020
In Press: 18/09/2020
Published: 22/10/2020

Abstract

OBJECTIVES:
To capture comorbidity and medication of persons with Sjögren’s syndrome (SS) in a population-based cohort in comparison to matched controls.
METHODS:
Individuals with an outpatient diagnosis of M35.0 (ICD-10) in ≥2 quarters of a year or an inpatient diagnosis of M35.0 were identified in a German statutory health insurance fund covering 7.2 million people. Persons in rheumatologic care were grouped by incident or prevalent diagnosis and by co-existing autoimmune disease (sSS) or primary (p)SS and compared to age- and sex-matched controls regarding comorbidity (ICD-10), medical prescriptions, hospitalisation and inability to work in the previous year.
RESULTS:
In 2018, 7,283 persons (0.10%) had incident and 54,273 persons (0.75%) prevalent SS diagnosis, and 5,961 (11%) were in rheumatologic care. Of these (90% female, mean age 66 years), 3,457 (58%) had further autoimmune disease (sSS), mostly rheumatoid arthritis (80%) and systemic lupus erythematosus (13%). Compared to controls, frequent comorbid conditions in SS were hypertension (controls: 52%, pSS: 55%, sSS: 63%), osteoarthritis (22%/40%/47%), osteoporosis (10%/26%/38%) and depression (21%/34%/36%). Systemic antirheumatic drugs were prescribed in 31% (pSS) and 66% (sSS) while < 5% received topical therapies. Glucocorticoids (8%/34%/59%), NSAIDs (28%/41%/45%), opioids (8%/15%/21%), analgesics (19%/30%/36%) and antidepressants (14%/21%/21%) were frequently prescribed. Compared to controls, hospitalisation (21%/32%/39%) and inability to work in persons <65 years (41%/48%/44%, median days 17/24/30) were more frequent in pSS and sSS than in controls.
CONCLUSIONS:
SS claims diagnosis is associated with substantial comorbidity and frequent prescription of anti-inflammatory drugs, analgesics and antidepressants. The individual and societal burden of SS shows that, in addition to effective treatment strategies, intensive attention to comorbidities is important in this disease.

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