Relationship between Chinese Herbal Medicine Use and Risk of Sjögren’s Syndrome in Patients with Rheumatoid Arthritis: A Retrospective, Population-Based, Nested Case-Control Study

Abstract

Background and Objectives: Sjögren’s Syndrome (SS) is a common extra-articular feature among subjects with rheumatoid arthritis (RA). While Chinese herbal medicine (CHM) has been used to treat symptoms of RA for many years, few studies have examined its efficacy in guarding against the SS onset. This study aimed to compare risk of SS for RA patients with and without use of CHM. Materials and Methods: Data obtained for this nested case-control study were retrieved from Taiwanese nationwide insurance database from 2000–2013. Cases with SS claims were defined and matched to two randomly selected controls without SS from the recruited RA cohorts. Risk of SS in relation to CHM use was estimated by fitting multiple conditional logistic regression. Results: Patients aged between 20 and 80 years were included and 916 patients with incident SS were matched to 1832 non-SS controls by age, sex and index year. Among them, 28.1% and 48.4% cases ever received CHM therapy, respectively. After adjusting for baseline characteristics, CHM use was found to be related to a lower risk of SS among them (adjusted odds ratio = 0.40, 95% confidence interval: 0.34–0.47). A dose-dependent, reverse association, was further detected between the cumulative duration of CHM use and SS risk. Those receiving CHM therapy for more than 730 days showed a significantly reduced risk of SS by 83%. Conclusions: Findings of this study indicated that the add-on CHM formula, as part of RA care, may be a beneficial treatment for prevention against the incident SS.

Research on the academic thought of distinguished veteran doctors of traditional Chinese medicine based on Mendelian randomization: a case study of the causation between Sjögren’s syndrome and rheumatoid arthritis

“…Thus, dryness is both a pathologic factor and a pathologic result. It has been demonstrated that TCM has achieved notable clinical efficacy in the diagnosis and treatment of SS combined with RA, especially in controlling disease progression and recurrence [17] . However, since traditional observational research fails to exclude confounding factors, whether there is a causal relationship between SS and RA remains unknown.…”

Rheumatic Diseases: New Progress in Clinical Research and Pathogenesis

“…Besides Western medicine, Chinese medicine and complementary therapies have been extensively investigated for their potential use in treating rheumatic diseases [ 9 , 10 ]. Liao et al demonstrated that patients with RA using Chinese medicine could reduce the risk of developing Sjögren’s Syndrome, a common extra-articular manifestation of RA [ 11 ]. Regarding complementary therapy usage, our previous study found that more than 85% of Taiwanese patients with SLE used complementary therapies on a regular basis [ 12 ].…”