Autonomic symptoms are common and are associated with overall symptom burden and disease activity in primary Sjogrens syndrome

Annals of Rheumatic Diseases, 05/11/2012

Newton JL et al. – Autonomic symptoms are common among patients with primary Sjögren's syndrome (PSS) and may contribute to the overall burden of symptoms and link with systemic disease activity.


  • Multicentre, prospective, cross–sectional study of a UK cohort of 317 patients with clinically well–characterised PSS.
  • Symptoms of autonomic dysfunction were assessed using a validated instrument, the Composite Autonomic Symptom Scale (COMPASS).
  • The data were compared with an age– and sex–matched cohort of 317 community controls.
  • The relationships between symptoms of dysautonomia and various clinical features of PSS were analysed using regression analysis.


  • COMPASS scores were significantly higher in patients with PSS than in age– and sex–matched community controls (median (IQR) 35.5 (20.9–46.0) vs 14.8 (4.4–30.2), p<0.0001).
  • Nearly 55% of patients (vs 20% of community controls, p<0.0001) had a COMPASS score >32.5, a cut–off value indicative of autonomic dysfunction.
  • Furthermore, the COMPASS total score correlated independently with EULAR Sjögren's Syndrome Patient Reported Index (a composite measure of the overall burden of symptoms experienced by patients with PSS) (β=0.38, p<0.001) and disease activity measured using the EULAR Sjögren's Syndrome Disease Activity Index (β=0.13, p<0.009).

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