Patients with pemphigus are at an increased risk of developing rheumatoid arthritis: a large-scale cohort study
- PDF / 313,551 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 16 Downloads / 183 Views
ORIGINAL ARTICLE
Patients with pemphigus are at an increased risk of developing rheumatoid arthritis: a large-scale cohort study Khalaf Kridin 1 & Virginia A. Jones 2 & Payal M. Patel 2 & Shira Zelber-Sagi 3 & Christoph M. Hammers 1 & Giovanni Damiani 4 & Kyle T. Amber 2 & Arnon D. Cohen 5 Received: 12 June 2020 / Accepted: 22 October 2020 # The Author(s) 2020
Abstract Data regarding the association between pemphigus and rheumatoid arthritis (RA) is inconclusive and yet to be firmly established. In the current study, we aimed to evaluate the risk of developing RA during the course of pemphigus. A large-scale populationbased longitudinal cohort study was conducted to evaluate the hazard ratio (HR) of RA among 1985 patients with pemphigus relative to 9874 age-, sex-, and ethnicity-matched control subjects. A multivariate Cox regression model was utilized. The incidence of RA was 1.07 (95% CI, 0.62–1.72) and 0.36 (95% CI, 0.24–0.52) per 1000 person-years among patients with pemphigus and controls, respectively. The lifetime prevalence of RA was 2.3% (95% CI, 1.7–3.1%) among cases and 1.8% (95% CI, 1.5–2.0%) among controls. Patients with pemphigus were more than twice as likely to develop RA as compared to control subjects (adjusted HR, 2.54; 95% confidence interval [CI], 1.31–4.92). The increased risk was robust to a sensitivity analysis that included only cases managed by pemphigus-related systemic medications (adjusted HR, 2.56; 95% CI, 1.30–5.05). In conclusion, pemphigus is associated with an increased risk of RA. Physicians treating patients with pemphigus should be aware of this possible association. Further research is required to better understand the mechanism underlying this association. Keywords Rheumatoid arthritis . Pemphigus . Cohort study
Introduction Pemphigus encompasses a group of rare, potentially lethal, mucocutaneous autoimmune bullous dermatoses [1]. These intraepidermal bullous diseases manifest with vesicles and erosions on the epithelium of mucous membranes and skin, often causing a substantial impairment of quality of life and
Kyle T. Amber and Arnon D. Cohen contributed equally to this work. * Khalaf Kridin [email protected]; [email protected] 1
Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
2
Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
3
University of Haifa, Haifa, Israel
4
Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
5
Clalit Health Services, Tel-Aviv, Israel
elevated morbidity and mortality [2, 3]. The pathogenesis results from the production of IgG autoantibodies against epidermal cadherins [4, 5]. It is well studied that autoimmune disease, such as pemphigus, is likely to coexist within individuals and their relatives [6–8]. Several studies have substantiated the concept of autoimmune diathesis in pemphigus with an array of autoimmune diseases [1]. Rrheumatoid arthritis (RA) is a chronic, usually symmetric, inflammatory autoimmune dis
Data Loading...
