The frequency, predictors, and treatment options of spondyloarthritis in primary Sjögren’s syndrome: a single-center experience

The aim of this study is to define the frequency and predictors of axial spondyloarthritis and treatment options in patients with Sjögren syndrome. In our study, the frequency of spondyloarthritis according to the International Association for the Assessment of Spondyloarthritis (ASAS) criteria was investigated in 84 patients who were diagnosed with primary Sjögren syndrome according to the 2016 ACR / EULAR (American College of Rheumatology/European Association of Rheumatology Associations) classification criteria in the Internal Medicine Rheumatology clinic of our hospital between November 2023 and January 2025. Patients' age, gender, HLAB-27, anti-nuclear antibody (ANA), anti-SSA, anti-SSB, inflammatory back pain, presence of sacroiliitis on sacroiliac joint magnetic resonance imaging (MRI), medications used, and Sjögren syndrome complications were recorded retrospectively. A total of 94% of the patients were female and 6% were male. The median age was 51 years. Axial spondyloarthritis (axSpA) was detected in 27% of the patients. Among those who developed axial spondyloarthritis, 15 patients received nonsteroidal anti-inflammatory drugs (NSAIDs), 5 patients received sulfasalazine, 1 patient received methotrexate, 1 patient received TNF (tumor necrosis factor) inhibitor, and 1 patient received secukinumab treatment. Four of those who received sulfasalazine had anterior uveitis and 1 had enthesitis. The only variable found to be associated with the presence of axial spondyloarthritis in primary Sjögren syndrome was ANA (p value: 0.006). Spondyloarthritis is not uncommon in primary Sjögren syndrome. ANA has been found to be associated with the presence of axial spondyloarthritis in primary Sjögren syndrome and has the potential for further research.