AB0324 ALLERGIC DISORDERS AND DRUG ALLERGIES IN PRIMARY SJÖGREN’S SYNDROME AND RHEUMATOID ARTHRITIS
Authors: M. Higashida-Konishi, K. Izumi, S. Hama, H. Takei, H. Oshima, Y. Okano
Journal: Annals of the Rheumatic Diseases (2021)

Background: Allergic disorders have been reported in a variety of rheumatic diseases. A high prevalence of allergic disorders was found in patients with Sjoegren’s syndrome [1]. Nevertheless, it was not clear what is a risk factor for allergic disorders and drug allergies in patients with primary Sjögren’s syndrome (pSS). Drug allergies may lead to delayed treatment and unnecessary clinical tests. Objectives: The primary aim of this study was to compare the prevalence of allergic disorders and drug allergies in patients with pSS and rheumatoid arthritis (RA). The secondary aim was to compare the clinical features with and without drug allergies in patients with pSS. Methods: We retrospectively examined consecutive patients diagnosed with pSS or RA in our hospital from 2010 to 2020. The patients with SS met the criteria of the 1999 revised Japanese Ministry of Health criteria[2]. We included patients with pSS without RA or other rheumatic diseases. The patients with RA met the EULAR/ACR 2010 criteria. We included patients with RA without other rheumatic diseases. The first analysis was performed on six types of allergic reactions: (1) food allergy (exanthema, angioedema and anaphylaxis after foods exposure), (2) drug allergy (exanthema, angioedema and anaphylaxis after drug exposure), (3) allergic contact dermatitis such as metals, alcohol swab, and other cosmetics, (4) seasonal allergic rhinitis and/or allergic conjunctivitis, and allergic rhinitis and/or allergic conjunctivitis associated with house dust, (5) asthma, and (6) atopic dermatitis. The secondary analysis was performed on patient baseline laboratory data at diagnosis of pSS and RA patients with or without drug allergies. Results: In the first analysis, 292 patients with pSS and 413 patients with RA were enrolled (Table 1). The mean ages (pSS, RA) were 57.3±15.8, 66.0±14.6 years old. Females were 94.2%, 78.2%. The mean observation period was 82.7±70.8, 65.6±37.0 months. 54.8% of pSS patients and 34.9% of RA patients presented at least one type of allergic disorders or drug allergies. These included food allergy, drug allergy, allergic rhinitis/conjunctivitis, asthma, and atopic dermatitis. Allergic disorders and drug allergies were more frequent in patients with pSS. In the second analysis, 77 patients with drug allergies and 215 patients without drug allergies were enrolled. The mean ages with drug allergies and without drug allergies were 56.0±15.8 and 57.8±15.8 years old, respectively; females were 96.1% and 93.5%; the mean observation period was 90.9±72.4 and 79.8±70.2 months. The pSS patients with drug allergies had higher levels of Immunoglobulin G (IgG) (2028±1409 mg/dL, 1726±587 mg/dL: p = 0.01), higher levels of eosinophils (220±247/μL, 126±112/μL: p&lt;0.019), and higher positivity rate of anti–Sjögren’s-syndrome-related antigen A autoantibody (anti-SSA antibody) than those without drug allergies (89.6%, 79.7%: p = 0.06). Conclusion: Patients with pSS had a higher prevalence of allergic disorders and drug allergies than patients with RA. Among patients with pSS, patients with drug allergies had higher levels of IgG, higher levels of eosinophils, and higher positivity rate of anti-SSA antibody than those without drug allergies. Table 1. Allergic Disorders and Drug Allergies in pSS and RA pSS (n = 292) RA (n = 413) P at least one type of allergy, n (%) 160 (54.8) 144 (34.9) &lt;0.01 food allergy, n (%) 35 (12.0) 27 (6.7) 0.02 drug allergy, n (%) 76 (26.1) 69 (16.7) &lt;0.01 allergic contact dermatitis, n (%) 10 (3.4) 19 (4.6) 0.6 allergic rhinitis and/or conjunctivitis, n (%) 99 (33.9) 35 (8.5) &lt;0.01 asthma, n (%) 29 (9.9) 25 (6.1) 0.06 atopic dermatitis, n (%) 15 (5.1) 0 (0) &lt;0.01 References: [1]Hama et al. Clinical features of patients with Sjoegren syndrome associated with adult onset Still’s disease. Japan College of Rheumatology Annual Congress 2020. [2]Fujibayashi et al. Revised Japanese criteria for Sjögren’s syndrome (1999): availability and validity. Mod Rheumatol. 2004; 14: 425-34. Disclosure of Interests: None declared