Clinical profile of secondary Sjögren's syndrome in women with rheumatoid arthritis

Abstract

Background. Secondary Sjögren syndrome in rheumatoid arthritis was identified as a common autoimmune complication in women, damaging joints and quality of life. Its prevalence increased with age, yet age-specific clinical patterns remained unclear; defining them could refine therapy, guide follow-up and improve outcomes. Objective(s). To compare the frequency and clinical features of secondary Sjögren syndrome among women with rheumatoid arthritis aged 30–40 and 50–70 years, highlighting key differences to inform care. Materials and methods. Included sources comprised a meta-analysis and large multicenter cohorts from the United States, Switzerland, Korea, and Taiwan, published between 2020 and 2025. For each study mean age, frequency of secondary Sjögren syndrome and major clinical signs were extracted, and findings were summarized descriptively and comparatively. Results. Secondary Sjögren syndrome was identified in 8% of women aged 30–40 years and in 28% of those aged 50–70 years. Younger participants generally presented mild sicca syndrome manifestations, moderate fatigue and sporadic parotid swelling, with a mean DAS28 of 3.4. Older participants often exhibited severe dryness, persistent parotid enlargement, advanced erosive arthritis, peripheral neuropathy, interstitial lung fibrosis and cutaneous vasculitis; their mean DAS-28 reached 5.3. Increasing disease duration was associated with greater symptom load, higher rheumatoid factor titers, and a steadily rising severity index for each disease year. Conclusion(s). Secondary Sjögren syndrome was found to be more prevalent and clinically severe in older women with rheumatoid arthritis. Annual screening beyond 50 years and early individualized treatment based on sicca syndrome grade and systemic signs were advised to curb joint and systemic damage.