Interstitial Lung Disease Common in Chinese Sjögren’s Patients, Worsens Quality of Life, Study Reports

Interstitial lung disease (ILD), or lung tissue scarring, commonly occurs in people with primary Sjögren’s syndrome in China and significantly burdens their quality of life, in particular their physical capacity, a Chinese study reports.

Strengthening early interventions and treatment is of great importance in preventing ILD and improving patients’ well-being, the researchers said.

The study, “Associated factors with interstitial lung disease and health-related quality of life in Chinese patients with primary Sjögren’s syndrome,” was published in the journal Clinical Rheumatology.

The progressive scarring of lung tissue, called interstitial lung disease or ILD, is the most common complication among people with primary Sjögren’s syndrome (pSS) and one of the main causes of death. The scarring causes stiffness in the lungs, which may cause shortness of breath and dry cough.

Chest computed tomography (CT) scans are the gold standard for ILD diagnosis. High-resolution CT (HRCT) imaging is particularly helpful for determining the extent of lung damage, narrowing down diagnosis, and guiding treatment decisions.

Few studies have investigated the risk factors for developing ILD and how it affects the quality of life in Sjögren’s patients. Even less of this research has been done in China.

To address this gap in knowledge, researchers now conducted a cross-sectional study to investigate the current situation of people with pSS-ILD in China. The study’s goal was to evaluate the relationship between this complication and quality of life in Chinese patients.

The study examined 101 adult Sjögren’s patients (mean age 51.6 years; 96.7% women) referred to the Affiliated Hospital of Nantong University. Researchers examined the participants’ demographic features, disease activity, anxiety and depression, clinical variables, laboratory values, and health-related quality of life.

Disease activity was measured by two recently developed instruments: the European League Against Rheumatism Sjögren’s Syndrome Disease Activity Index (ESSDAI), a physician-assessed scale for determining systemic disease activity, and the EULAR Sjögren’s Syndrome Patient-Reported Index (ESSPRI), a patient-completed questionnaire for assessing disease symptoms.

Quality of life and psychological health of patients also were assessed using specific patient-reported surveys.

HRCT and pulmonary function tests indicated that 28 of 101 participants had ILD, corresponding to an ILD incidence of 30.1%. The presence and development of ILD were associated with longer disease duration and greater levels of fatigue.

Patients who developed ILD also had higher blood levels of a liver enzyme (a marker of liver damage), higher counts of neutrophils (a type of white blood cells), and lower levels of albumin (a marker than can indicate problems in the liver or kidneys).

ILD also was associated with less frequent use of hormone therapy.

The survey indicated that ILD significantly worsened these individuals’ quality of life, especially their physical abilities and emotional status.

Given the significant negative impact of ILD on patients’ well-being, researchers called on doctors to “pay more attention to patients.”

“During the next treatment process, doctors should pay attention to the QoL [quality of life] of patients with ILD, which is of great significance to improve the management of disease and treatment decisions,” they concluded.