A prospective study of sicca symptoms in patients with rheumatoid arthritis

OBJECTIVE: To investigate sicca symptoms in patients with rheumatoid arthritis (RA) with respect to constancy, temporal changes of prevalence, and possible risk factors. METHODS: A prospective cohort study of 70 patients with RA was conducted over 5 years. The main variables of interest were the 6 questions on sicca symptoms used in the preliminary European criteria for Sj?gren's syndrome. RESULTS: Fourteen patients were lost to followup. We found that 84.2% (95% confidence interval [95% CI] 59.5-95.8) of the patients reporting sicca symptoms at baseline also reported them at followup. During the study period, sicca symptoms increased by 52.6% in general (P = 0.02) and by 80.0% for the ocular components (P = 0.04). Sicca symptoms (odds ratio [OR] = 8.35, 95% CI 1.91-36.49) and pain (OR = 1.03, 95% CI 1.00-1.07) at baseline were identified as independent predictive factors for sicca symptoms at followup. CONCLUSIONS: Sicca symptoms in patients with RA are remarkably constant over time. There is also a substantial time-dependent increase in the prevalence of such symptoms. As the prevalence of ocular sicca symptoms in general populations tend to level out with age, there seems to be a disease-related increase of ocular symptoms over time in patients with RA. Present pain and sicca symptoms constitute risk factors for future sicca symptoms.