ASSOCIATION BETWEEN A HISTORY OF MYCOBACTERIAL INFECTION AND THE RISK OF SJÖGREN'S SYNDROME: A NATIONWIDE, POPULATION-BASED CASE-CONTROL STUDY

Background: An increased risk of tuberculosis (TB) has been found in subjects with Sjögren's syndrome (SS); however, whether TB or nontuberculous mycobacteria (NTM) infection is associated with the risk of SS is still unknown. Objectives: To explore the association between a history of mycobacterial infection and the risk of newly diagnosed SS. Methods: After excluding those who had rheumatoid arthritis and systemic lupus erythematosus, we identified 5,751 newly diagnosed SS cases and 86,265 non-SS patients matched (1:15) for age, sex, and the year of first diagnosis date as controls using nationwide, population-based, claims data. The association between the risk of incident SS and a history of treated mycobacterial infection, including TB and NTM, was quantified by odds ratios (ORs) with 95% confidence intervals (CIs) using conditional logistic regression analysis after adjusting for Charlson comorbidity index (CCI) and bronchiectasis. Results: The mean ± SD age was 55±14 years and the proportion of female gender was 87.8% in newly diagnosed SS cases and non-SS controls. An association was observed between NTM infection (OR, 11.24; 95% CI, 2.37–53.24) and incident SS, but not between TB infection and incident SS (OR, 1.29; 95% CI, 0.97–1.71) after adjustment for CCI and bronchiectasis. The magnitude of the association between NTM and SS risk was greatest among those aged between 45 and 65 years (OR, 39.24; 95% CI, 3.97–387.75). Univariable analysisMultivariable analysis OR (95% CI)OR (95% CI) Nontuberculous mycobacteria20.00 (4.48–89.36)11.24 (2.37–53.24) Tuberculosis1.86 (1.41–2.45)1.29 (0.97–1.71) CCI ≥11.89 (1.77–2.01)1.83 (1.71–1.94) Bronchiectasis3.19 (2.76–3.69)2.74 (2.36–3.18) Conclusions: The present study demonstrates a statistically significant association of newly-diagnosed SS with a history of NTM, but not TB infection. References: Peri Y, Agmon-Levin N, Theodor E, et al. Sjogren's syndrome, the old and the new. Best practice & research Clinical rheumatology 2012;26(1):105–17. Mavragani CP, Moutsopoulos HM. The geoepidemiology of Sjogren's syndrome. Autoimmunity reviews 2010;9(5):A305–10. Elkington P, Tebruegge M, Mansour S. Tuberculosis: An Infection-Initiated Autoimmune Disease? Trends in immunology 2016. Acknowledgements: The authors would like to thank the Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan, ROC for statistical support. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2017-eular.1288Citation: Annals of the Rheumatic Diseases, volume 76, supplement 2, year 2017, page 82Session: Risk factors for developing diseases or comorbidities (Oral Presentations )