Prevalence and incidence of Sjögren's disease in Alaska Native and American Indian peoples of Alaska.

Abstract

Objective: Our objective was to determine the prevalence, incidence, and clinical characteristics of Sjögren's disease in Alaska Native and American Indian (AN/AI) peoples of Alaska.

Methods: We identified adults with Sjögren's disease by querying electronic health records from participating tribal health organizations within the Alaska Tribal Health System (ATHS). Medical records were abstracted for adults with diagnostic codes for Sjogren's disease. Individuals were included if they were diagnosed with Sjogren's disease by a rheumatologist). Prevalence and incidence were calculated using the ATHS user population in 2019 (point prevalence) and from 2012-2019 (incidence), with direct age-adjustment to the U.S. 2000 standard population. We evaluated whether adults met modified criteria (positive Ro/SSA antigen with sicca symptoms), 2016 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR), and 2012 ACR criteria.

Results: The age-adjusted prevalence of Sjögren's disease was 199 per 100,000 adults (95% confidence interval 170, 231); for primary Sjögren's disease it was 129 (106, 155), and for secondary Sjögren's disease it was 70 (54, 91). The age-adjusted incidence over the period was 16.6 (13.7, 20.0) per 100,000 person years. Two-thirds (66%) of adults met modified criteria. Only 5% had a salivary gland biopsy performed and only 3% met 2016 ACR/EULAR or 2012 ACR criteria. The most common associated conditions in secondary Sjögren's disease were rheumatoid arthritis and systemic lupus erythematosus.

Conclusion: The prevalence and incidence of Sjögren's disease in AN/AI peoples is higher than other populations. These results may help clinicians to identify and treat this condition.