We appreciate the comments of Kassimos and colleagues concerning our report of the occurrence of symptoms of dry eye and dry mouth in an elderly population and the lack of association of these symptoms with rheumatoid arthritis. Kassimos and colleagues1 previously reported a case series of 26 patients with NOA who were identified because they attended a specialized Sjögren syndrome clinic with the complaint of xerostomia. They then studied 35 patients with NOA and 18 controls from a rheumatology clinic for the presence of symptoms of dry eye and dry mouth and performed whole salivary flow rate and Schirmer tests. Only 4 (12%) of the NOA patients and 2 (11%) of the controls reported both dry eye and dry mouth symptoms; these were not considered serious. While there were no differences in lacrimal flow rates, there was a difference in whole salivary flow rates that correlated with the presence of xerostomia. We do not find these data compelling enough to support the existence of a new syndrome in the elderly.
Hochberg MC, Schein OD. Dry Eyes and Dry Mouth in Patients With Generalized Nodal Osteoarthritis—Reply. Arch Intern Med. 2001;161(4):615. doi: