Sex differences in patient-reported outcome measures and clinical parameters in patients with Sjögren's disease

To explore sex differences in patient-reported outcome measures (PROMs) and clinical parameters in patients with Sjögren's disease (SjD).

Consecutive patients with clinical diagnosis of SjD, enrolled in the prospective RESULT cohort or retrospective DiagnoSS registry, who fulfilled 2016 ACR/EULAR classification criteria, were included. PROMs evaluating sicca symptoms, fatigue, pain and health-related quality of life (HR-QoL), and clinical parameters including salivary and ocular gland function, salivary gland ultrasound (SGUS) and biopsy outcomes, physical examination results, serological parameters, systemic disease activity and damage were compared between female and male patients.

Of the 405 SjD patients, 360 (89%) were female and 45 (11%) were male. Females had earlier onset of symptoms (median 37 vs. 51 years), longer diagnostic delay (5 vs. 3 years), scored worse on PROMs assessing sicca symptoms (e.g. ESSPRI dryness median 7 vs. 5), had lower salivary gland function (SWS, UWS; UWS<0.1ml/min: 69% vs. 44%), and more tender points than male patients. ESSDAI total score did not differ, but female patients less often had pulmonary (1.7% vs. 6.7%) and peripheral nervous system activity (3.4% vs. 11.1%) than male patients. Clinical parameters including ocular tests, SGUS (Hocevar), biopsy parameters, immunological serology and damage (SSDDI) did not differ. HR-QoL (SF-36, EQ-5D-5L: index median 0.76 vs. 0.74) and PASS (72% vs. 70%) were comparable between sexes.

In this cohort of SjD patients from daily clinical practice, female and male patients showed distinct patterns of experienced symptoms and disease manifestations. The overall impact of SjD on HR-QoL was similar.