Prevalence and Incidence of Sjögren's Disease in Alaska Native and American Indian Peoples of Alaska.

Abstract

Our objective was to determine the prevalence, incidence, and clinical characteristics of Sjögren's disease (SjD) in Alaska Native and American Indian (AN/AI) peoples of Alaska. We identified adults with SjD 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 SjD. Individuals were included if they were diagnosed with SjD by a rheumatologist. Prevalence and incidence were calculated using the ATHS user population in 2019 (point prevalence) and from 2012 to 2019 (incidence), with direct age adjustment to the 2000 standard US population. We evaluated whether adults met modified criteria (positive Ro/SSA antigen with sicca symptoms), 2016 American College of Rheumatology (ACR)/EULAR, and 2012 ACR criteria. The age-adjusted prevalence of SjD was 199 per 100,000 adults (95% confidence interval [CI] 170-231); for primary SjD, it was 129 (106, 155), and for secondary SjD, it was 70 (95% CI 54-91). The age-adjusted incidence over the period was 16.6 (95% CI 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 the 2016 ACR/EULAR or 2012 ACR criteria. The most common associated conditions in secondary SjD were rheumatoid arthritis and systemic lupus erythematosus. The prevalence and incidence of SjD in AN/AI peoples is higher than other populations. These results may help clinicians to identify and treat this condition.