Risk factors in systemic lupus erythematosus-associated Sjögren's syndrome: multicenter case-control studies and systematic review.

Objective: The study identifies risk factors for SLE-associated Sjögren's syndrome (SLE-SS), based on multiple cohorts and meta-analysis.

Methods: Three cohorts (Luzhou cohort, Enshi cohort, and Chengdu cohort) were initially conducted, and clinical, laboratory characteristics from patients with SLE-only and SLE-SS patients were collected and we discussed risk factors related to SLE-SS. Subsequently, a meta-analysis discussed risk factors related to SLE-SS risk from published articles and our studies.

Results: For original cohort studies, 1904 SLE patients were included in the Luzhou cohort, and there were 36 SLE-SS patients. Results showed that factors such as age (OR = 1.07), anti-SSB ( +) (OR = 3.68), and anti-RNP ( +) (OR = 3.42) were risk factors for SLE-SS risk. In the Enshi cohort, 386 SLE patients were included, and there were 18 SLE-SS patients. Results showed that factors such as age (OR = 1.10), ANA ( +) (OR = 0.08), and RF ( +) (OR = 20.09) were positively related to SLE-SS risk. For the Chengdu cohort, 658 SLE patients were recruited, and 88 were SLE-SS patients. Factors such as age (OR = 1.03), ANA ( +) (OR = 0.40), anti-SSA ( +) (OR = 6.23), and anti-SSB ( +) (OR = 3.03) were risk factors for SLE-SS development. In the meta-analysis, 15 original studies were discussed. The meta-analysis identified several risk factors for SLE-SS, including age, anti-SSA ( +), anti-SSB ( +), RF ( +), Raynaud's phenomenon ( +), hematuria ( +) and pulmonary involvement ( +).

Conclusion: Age, autoantibodies (including anti-SSA, anti-SSB, and anti-RNP), RF, and clinical features (including Raynaud's phenomenon, hematuria, and pulmonary involvement) serve as risk factors for SLE-SS patients. Key Points • Age is a demographic risk factor for SLE-SS; clinical and laboratory characteristics like Raynaud's phenomenon, hematuria, anti-SSA (+) are SLE-SS risk factors. • Meta-analysis showed that characteristics like pulmonary involvement (+), anti-SSB (+), and RF (+) as additional risk factors distinguished SLE-SS patients.