Incidence, prevalence, and predictors of inflammatory arthritis in patients with hidradenitis suppurativa: a systematic review and meta‐analysis

Abstract

An increasing amount of evidence has emerged suggesting that hidradenitis suppurativa (HS) is associated with inflammatory arthritis. This study reviewed the incidence, prevalence, and predictors of inflammatory arthritis in patients with HS. A comprehensive literature search was conducted in CINAHL, Embase, and Medline from inception to February 14, 2020. Articles were included in the review if they provided data on disease epidemiology or predictors of adult or pediatric HS patients with comorbid inflammatory arthritis. There are no validated diagnostic criteria for HS, thus we considered patients as having HS if they had at least one diagnostic code in a hospital or claims database or a diagnosis of HS/inflammatory arthritis in a medical record. The same criteria were used to confirm presence of inflammatory arthritis. We identified an increased incidence of rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) in HS patients when compared with estimates in the general population. We identified a relatively high prevalence of RA, spondyloarthritis (SpA), and PsA in HS patients when compared with estimates in the general population. There was evidence to suggest that patients who are younger than 30, male, have severe HS, or are taking infliximab or adalimumab (which may also be confounded by HS disease severity) may be at greater risk for specific subtypes of inflammatory arthritis. However, further data are needed to confirm these associations. The increased incidence and prevalence of inflammatory arthritis within HS patients underscore the need for increased awareness and interdisciplinary partnership within rheumatology and dermatology.

Risk of osteoarthritis in patients with hidradenitis suppurativa: a global federated health network analysis

“…Given these conditions, the issue of HS comorbidities had long been discussed and was acknowledged as intricate, encompassing several different functional problems including allergic status ( 25 ), gastrointestinal dysfunctions ( 26 , 27 ), and renal diseases ( 28 ). Among the comorbidities of HS, integrated pieces of evidence had suggested that spondyloarthritis and rheumatoid arthritis were of high prevalence and incidence in the HS population ( 6 , 29 ). A recent small-scale case-control study stated that some of the bone function indicators, such as trabecular bone score and hip bone mineral density, were low in patients with HS compared with that in controls ( 30 ).…”

Vulvar skin disease in the pediatric population

“…Given the delay of diagnosis of nearly 2 years after symptom onset, in conjunction with the misdiagnosis with infection, this is likely an underestimate of the true prevalence [24]. HS has an immense physical and psychosocial burden, as it has been associated with increased rates of comorbid depression, anxiety, atopy, and metabolic disorders, as well as inflammatory conditions including inflammatory bowel disease and inflammatory arthritis [23 ▪ ,24,25 ▪ ,26–28]. A newly published systematic review and meta-analysis of 12 studies showed significantly increased odds of asthma and atopic dermatitis among HS patients [26].…”

Practical Guidelines for Managing Patients With Hidradenitis Suppurativa: An Update

“…Rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis are more common in HS patients. 21,37 -39 A 2021 meta-analysis found that the total prevalence of inflammatory arthritis is about 1.9% in the HS patient population (95% CI 0.58-6.12). 37…”

“…21,37 -39 A 2021 meta-analysis found that the total prevalence of inflammatory arthritis is about 1.9% in the HS patient population (95% CI 0.58-6.12). 37…”