Sjögren's disease & overlap diseases
Beyond co-occurrence: Age, sex, and the temporal progression of autoimmune overlap syndromes in a 23-year nationwide cohort
Authors' conclusion
Overlapping ARDs affected nearly one-quarter of Taiwanese patients, with most emerging within 3 years of the initial diagnosis.
Study context
- Population
- Patients newly diagnosed with one of nine common autoimmune rheumatic diseases (ARDs), 2000–2022, Taiwan's National Health Insurance Research Databaseincident ARD
- Participants
- 235,592 patients
- Exposure
- Co-occurring vs sequential overlap syndromes of autoimmune rheumatic diseases (ARDs)
- Outcome
- Development of an overlapping ARD (second ARD diagnosis)
Methodological detailsTaiwan National Health Insurance Research Database (NHIRD), joinpoint regression analysis
- Taiwan NHIRD
- Joinpoint regression analysis
Main finding
As reported in the abstract
Overlapping syndrome among patients with an incident ARD
Developed an overlapping syndrome
22.2%
Observational data: associations, not effects.
Further findings
Factors associated with sequential overlap
- Younger age at onset significantly associated with sequential overlap (age at onset, years)
- 46.0 vs. 51.1
- Female sex significantly associated with sequential overlap
Most frequent co-occurring combination: SjD with SLE
- SjD with SLE, share of co-occurring cases
- 48.2%
Sequential overlaps: most frequent first and second diagnoses
- RA as most frequent first diagnosis
- 36.1%
- SjD the most frequent second autoimmune diagnosis overall
Timing of risk of a second ARD
- Risk highest in the first three years after initial diagnosis, then declined sharply; critical 3-4-year high-risk period
Original publication
Beyond co-occurrence: Age, sex, and the temporal progression of autoimmune overlap syndromes in a 23-year nationwide cohort. Semin Arthritis Rheum. Published 3 June 2026. doi:10.
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