Hidradenitis suppurativa and rheumatoid arthritis: evaluating the bidirectional association

Abstract

Despite some common pathogenic themes, the association of hidradenitis suppurativa (HS) and rheumatoid arthritis (RA) has been poorly investigated. We aimed to evaluate the bidirectional association between HS and RA. A population-based study was conducted to compare HS patients (n = 6779) with age-, sex- and ethnicity-matched control subjects (n = 33,260) with regard to the incidence of new-onset and the prevalence of preexisting RA. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were estimated. The prevalence of preexisting RA was greater among patients with HS relative to controls (0.5% vs 0.3%. respectively; p = 0.019). The odds of being diagnosed with HS were 1.6-fold higher in patients with a history of RA (fully-adjusted OR, 1.66; 95% CI, 1.11–2.49; p = 0.014). The incidence rate of new-onset RA was estimated at 4.3 (95% CI, 2.5–6.8) and 2.4 (95% CI, 1.8–3.2) cases per 10,000 person-years among patients with HS and controls, respectively. The risk of RA was comparable between patients with HS and controls (fully-adjusted HR, 1.45; 95% CI, 0.77–2.72; p = 0.249). Compared to other patients with HS, those with HS and comorbid RA were older, had a higher prevalence of diabetes mellitus, hypertension, and hyperlipidemia, and had a comparable risk of all-cause mortality. In conclusions, a preexisting diagnosis of RA predisposes individuals to develop HS. Clinicians managing patients with HS and RA should be aware of this association. Further research is required to delineate the underlying pathomechanism of this observation.

Epidemiology and comorbidity of hidradenitis suppurativa in Korea for 17 years: A nationwide population‐based cohort study

“…Furthermore, it is believed that there is an association between HS and autoimmune diseases. A recent study reported that the prevalence of RA was greater in patients with HS than in controls (aOR 1.66, 95% CI 1.11–2.49) 45 . In a meta‐analysis, there was a significant association between HS and ankylosing spondylitis (OR 1.89, 95% CI 1.14–3.12) and between HS and RA (OR 1.96, 95% CI 1.28–2.98) 46 .…”

“…A recent study reported that the prevalence of RA was greater in patients with HS than in controls (aOR 1.66, 95% CI 1.11-2.49). 45 In a meta-analysis, there was a significant association between HS and ankylosing spondylitis (OR 1.89, 95% CI 1.14-3.12) and between HS and RA (OR 1.96, 95% CI 1.28-2.98). 46 Similarly, in our study, RA was more prevalent and incident in patients with HS than in the control.…”

Methylated miRNAsmay serve as potential biomarkers and therapeutic targets for hidradenitis suppurativa

“…HS is also, regarded as a chronic inflammatory disease with several autoimmune, 63 inflammatory 64 and metabolic comorbidities 65 . Interestingly, miR‐132 also targets genes implicated in several HS comorbidities, such as the decrease in PLLP expression in psoriasis, 66 ATP6V1H decrease in type 2 diabetes adipose tissue 67 and ZBTB17 encoding of MIZ‐1 , which is associated with inflammation and tumour growth 68,69 .…”

“…This hypermethylation may have decreased the expression level of wound-healing markers, which correspondingly may have resulted in less healing of wounds or even in dysregulation of healing such as hypertrophic scars and keloids. HS is also, regarded as a chronic inflammatory disease with several autoimmune, 63 inflammatory 64 and metabolic comorbidities. 65 Interestingly, miR-132 also targets genes implicated in several HS comorbidities, such as the decrease in PLLP expression in psoriasis, 66 ATP6V1H decrease in type 2 diabetes adipose tissue 67 and ZBTB17 encoding of MIZ-1, which is associated with inflammation and tumour growth.…”

The Relevant Oral Burden of Patients with Hidradenitis Suppurativa

“…This recurrent condition is associated with an estimated prevalence of 1–4%, being more frequent in women and with an age onset typically between 20 and 40 years of age [ 2 – 6 ]. Local inflammation spillover of pro-inflammatory cytokines (tumor necrosis factor (TNFα), interleukin (IL)-1β, IL-12, IL-17, and IL-23) in the circulation sustains the rationale of HS-related comorbidities that may range from autoimmune (e.g., rheumatoid arthritis [ 7 ]) to metabolic ones (e.g., non-alcoholic fatty liver [ 8 ]) potentially involving the whole body including immunologically privileged areas such as the eye [ 9 ].…”