Increased risk of concurrent gastroesophageal reflux disease among patients with Sjögren's syndrome: A nationwide population-based study

• The risk of GERD among SS patients was 2.41-fold greater than that for the general population.
• The youngest SS patients had the highest risk and the lowest risk at age ≥ 65 years.
• SS patients without comorbidity had a 2.87-fold risk higher than comparison cohort.

BackgroundLittle data is available on the risk of gastroesophageal reflux disease in patients diagnosed with Sjögren's syndrome.MethodsWe identified 4650 Sjögren's syndrome patients between 2000 and 2011 from the National Health Insurance Research Database. Each Sjögren's syndrome patient was matched to 4 controls based on age, sex, and index year, and all subjects were followed up from the index date to December 31, 2011. Cox proportional hazards regression model was used to estimate the risk of gastroesophageal reflux disease.ResultsThe risk of gastroesophageal reflux disease for Sjögren's syndrome patients was 2.41-fold greater than that for the comparison cohort after adjusting for age, sex, and comorbidities. In age stratified analyses, the youngest Sjögren's syndrome cohort (age: 20–44 years old) had the highest risk (HR = 3.02; 95% CI = 2.48–3.69) and the lowest risk at age ≥ 65 years (HR = 1.95; 95% CI = 1.61–2.36). Regardless of in subjects with and without comorbidity, Sjögren's syndrome patients had a higher risk than the controls. Sjögren's syndrome subjects with ischemic heart disease, hyperlipidemia and renal disease had the highest risk for gastroesophageal reflux disease compared with the comparison cohort without those diseases (HR = 7.67; 95% CI = 5.32–11.1).ConclusionPatients with Sjögren's syndrome have a significantly greater risk of developing subsequent gastroesophageal reflux disease than the general population.