ArticleArthritis & rheumatology (Hoboken, N.J.)2022
Symptom-Based Cluster Analysis Categorizes Sjögren's Disease Subtypes: An International Cohort Study Highlighting Disease Severity and Treatment Discordance.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed.
- Clinical and Ultrasonographic Characterization of Proposed Sjögren's Disease Phenotypes in a Korean Longitudinal Cohort.Journal of clinical medicine · 2026Article
- Identifying symptom-based subgroups in Sjögren's disease: a latent class analysis of a patient co-designed survey.BMJ open ophthalmology · 2026Article
- Construction of a nomogram for anxiety and depression in patients with Sjögren's syndrome by combining tongue and pulse characteristics: a cross-sectional study based on a prospective cohort.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2026Article
- Sjögren Disease-B Cells at the Brink: From Autoimmunity to Lymphomagenesis and the Rise of Novel B Cell-Targeted Therapies.Arthritis & rheumatology (Hoboken, N.J.) · 2026Review
- From Molecular Pathophysiology to Clinical Trial Design in Sjögren's Disease: A Three-Axis Framework.International journal of molecular sciences · 2026Review
- Molecular classification of primary Sjögren's syndrome based on salivary gland omics.Arthritis research & therapy · 2026Article
- When Dryness Extends to the Brain: Brain-Related Non-Sicca Manifestations of Sjögren's Disease.Journal of clinical medicine · 2026Review
- Cracking the Code: Which Ocular Symptoms Predict Dry Eye Signs? Insights From a Large International Sicca Registry.Arthritis care & research · 2026Article
- Update on the Aetiopathogenesis of Sjögren Disease: From Interferon Signaling to Epithelial Dysfunction.Journal of clinical medicine · 2026Review
- Activity and Damage Indices for Sjögren's Disease.Journal of clinical medicine · 2026Review
- From immune activation to symptom burden: mechanisms and translational implications of immune-symptom uncoupling in Sjögren's disease.Frontiers in immunology · 2026Review
- Immunophenotypic Stratification of Primary Sjögren's Syndrome Reveals Distinct Lymphocyte Profiles and Clinical Manifestations.Journal of immunology research · 2026Article
- From endotypes to therapeutic targets: exploring the potential of precision treat-to-target approaches in primary Sjögren's disease.Clinical rheumatology · 2025Review
- Macular Microvasculature Is Different in Patients with Primary Sjögren's Disease Compared to Healthy Controls.Diagnostics (Basel, Switzerland) · 2025Article
- Insights into Patient Heterogeneity in Sjögren's Disease.International journal of molecular sciences · 2025Review
- 2023 International Rome consensus for the nomenclature of Sjögren disease.Nature reviews. Rheumatology · 2025Article
- Long-term changes in Sjögren's disease: a 9-year prospective follow-up study from the SJOGRENSER Registry.Rheumatology international · 2025Observational
- Differences in symptom clusters based on multidimensional symptom experience and symptom burden in stroke patients.Scientific reports · 2025Article
- Stability of symptom-based subtypes in Sjogren's disease.RMD open · 2024Article
- Sjögren's Disease and Gastroesophageal Reflux Disease: What Is Their Evidence-Based Link?Medicina (Kaunas, Lithuania) · 2024Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveAlthough symptom relief is a critical aspect for successful drug development in Sjögren's disease, patient experiences with Sjögren's-related symptoms are understudied. Our objective was to determine how pain, dryness, and fatigue, the cardinal symptoms of Sjögren's disease, drive cluster phenotypes.
methodsWe used data from the Sjögren's International Collaborative Clinical Alliance (SICCA) Registry and a Sjögren's Foundation survey. We performed hierarchical clustering of symptoms by levels of dryness, fatigue, and pain. Using international and US cohorts, we performed multiple logistic regression analysis to compare the clusters, which included comparisons of differences in symptoms, quality of life (QoL), medication use, and systemic manifestations.
resultsFour similar clusters were identified among 1,454 SICCA registrants and 2,920 Sjögren's Foundation survey participants: 1) low symptom burden in all categories (LSB); 2) dry with low pain and low fatigue (DLP); 3) dry with high pain and low to moderate fatigue (DHP); and 4) high symptom burden in all categories (HSB). Distribution of SICCA registrants matching the symptom profile for each cluster was 10% in the LSB cluster, 30% in the DLP cluster, 23% in the DHP cluster, and 37% in the HSB cluster. Distribution of survey participants matching the symptom profile for each cluster was 23% in the LSB cluster, 14% in the DLP cluster, 21% in the DHP cluster, and 42% in the HSB cluster. Individuals in the HSB cluster had more total symptoms and lower QoL but lower disease severity than those in the other clusters. Despite having milder disease as measured by laboratory tests and organ involvement, individuals in the HSB cluster received immunomodulatory treatment most often.
conclusionWe identified 4 symptom-based Sjögren's clusters and showed that symptom burden and immunomodulatory medication use do not correlate with Sjögren's end-organ or laboratory abnormalities. Findings highlight a discordance between objective measures and treatments and offer updates to proposed symptom-based clustering approaches.
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