Meta-analysis of mortality-associated factors in primary Sjögren's syndrome patients with interstitial lung disease.

Abstract

The study aims to conduct a meta-analysis on 5-year survival rate and mortality-related factors in the patients with primary Sjögren's syndrome concomitant with interstitial lung disease (pSS-ILD). Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched various platforms and databases until November 22, 2023. We used the Newcastle-Ottawa Scale (NOS) for quality assessment and extracted study characteristics and effect sizes. The pooled 5-year survival rate, hazard ratios (HRs), and the corresponding 95% confidence intervals (95% CIs) were then calculated. A p-value of less than 0.05 was considered statistically significant. Patients with pSS-ILD. Mortality in patients with pSS-ILD. Out of 188 articles, seven met the inclusion criteria. The meta-analysis estimated a 5-year survival rate of 82% (73%-91%). Mortality-related factors estimated by the meta-analysis included older age (HRs = 1.06, 95% CI 1.03-1.09, P < 0.0001), history of smoking (HRs = 3.44, 95% CI 2.14-5.53, P < 0.00001), anti-SSA antibody positivity (HRs = 0.41, 95% CI 0.20-0.85, P = 0.02), anti-SSB antibody positivity (HRs = 0.42, 95% CI 0.18-0.98, P = 0.04), reduced forced vital capacity (FVC; HRs = 0.96, 95% CI 0.95-0.98, P < 0.0001), reduced 6-min walk distance (6MWD; HRs = 0.99, 95% CI 0.99-1.00, P = 0.0008), presence of a reticular abnormality (HRs = 3.03, 95% CI 1.54-5.95, P = 0.001), and decreased arterial partial pressure of oxygen (PaO₂) levels (HRs = 0.99, 95% CI 0.97-1.00, P = 0.04). The 5-year survival rate for pSS-ILD is 82%. Older age, history of smoking, anti-SSA antibody negativity, anti-SSB antibody negativity, reduced FVC, reduced 6MWD, presence of a reticular abnormality, and decreased PaO₂ levels increase the mortality risk in pSS-ILD.