Patients with pemphigus are at an increased risk of developing rheumatoid arthritis: a large-scale cohort study

Kridin, Khalaf; Jones, Virginia; Patel, Payal M.; Zelber‐Sagi, Shira; Hammers, Christoph M; Damiani, Giovanni; Amber, Kyle T.; Cohen, Arnon D

doi:10.1007/s12026-020-09160-6

Cited by 6 publications

(6 citation statements)

References 30 publications

(47 reference statements)

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“…The latter additionally depicted an association between pemphigus and type 1 diabetes mellitus ( Parameswaran et al., 2015 ). In a recent retrospective cohort study, patients with pemphigus were found to be at a 2.5-fold increased risk of developing rheumatoid arthritis ( Kridin et al., 2020a ). Additional comorbidity was identified with Sjögren syndrome, systemic lupus erythematosus, and alopecia areata in a large-scale Taiwanese case-control study ( Chiu et al., 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Pemphigus

Kridin

Schmidt

2021

JID Innovations

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Pemphigus is an epidemiologically heterogeneous group of autoimmune bullous diseases comprising pemphigus vulgaris (PV), pemphigus foliaceus, paraneoplastic pemphigus, IgA pemphigus, and pemphigus herpetiformis. Recently, our knowledge about the frequency of pemphigus, which is highly variable between different populations, has considerably expanded, and the first non-HLA genes associated with PV have been identified. In addition, a variety of comorbidities, including other autoimmune diseases, hematological malignancies, and psoriasis, have been described in this variant. Here, initial data about the impact of COVID-19 on this fragile patient population are discussed and perspectives for future epidemiological studies are outlined.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of Pemphigus

Kridin

Schmidt

2021

JID Innovations

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“…It is still to be decisively determined which agents should be invariably preferred. This question is influenced by multiple determinants related to the disease (severity, duration, subtype), to the patient (age, sex, fertility potential, and comorbidities ( 21 )), as well as to other logistic considerations (domestic healthcare regulation, expenditure, availability of the drug). To complicate matters further, there is a lack of robust published evidence regarding the long-term efficacy and safety of these agents in pemphigus, principally owing to the scarcity of RCTs ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

Survival of Adjuvant Drugs for Treatment of Pemphigus: A Population-based Cohort Study

Kridin

Hammers²,

Ludwig³

et al. 2021

Acta Derm Venereol

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Drug survival reflects the real-life efficacy and safety of therapeutic agents. Evidence regarding the durability of adjuvant agents in the treatment of pemphigus is sparse. The aims of this study were to investigate the survival of adjuvant agents used to manage patients with pemphigus, and to identify predictors of treatment dropout. A retrospective population-based cohort study was designed to follow patients with pemphigus managed by adjuvant agents. The study population included 436 patients with pemphigus managed by 608 adjuvant agent courses. The highest median drug survival time was observed for rituximab (43.6 months, 95% confidence interval (95% CI) 5.3–81.9), followed by cyclophosphamide (30.5 months; 95% CI 10.5–50.5), azathioprine (22.9 months; 95% CI 15.6–30.2), and mycophenolate mofetil (20.2 months; 95% CI 10.0–30.4). Compared with azathioprine, cyclosporine (adjusted hazard ratio 2.98; 95% CI 1.57–5.62; p = 0.005) and dapsone (adjusted hazard ratio 1.83; 95% CI 1.07–3.15; p = 0.027) were associated with a significantly increased risk of drug discontinuation. To conclude, rituximab, azathioprine, and mycophenolate mofetil demonstrated better durability, whilst dapsone and cyclosporine were associated with low drug survival and high dropout.

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“…The diagnosis of RA was based on its documentation in the chronic registry of CHS. Cases of RA were defined on the grounds of documentation by board-certified rheumatologists, the purchase of RA-related drugs, and suggestive laboratory and imaging data [ 11 , 12 ].…”

Section: Methodsmentioning

confidence: 99%

Hidradenitis suppurativa and rheumatoid arthritis: evaluating the bidirectional association

et al. 2021

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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.

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Patients with pemphigus are at an increased risk of developing rheumatoid arthritis: a large-scale cohort study

Cited by 6 publications

References 30 publications

Epidemiology of Pemphigus

Epidemiology of Pemphigus

Survival of Adjuvant Drugs for Treatment of Pemphigus: A Population-based Cohort Study

Hidradenitis suppurativa and rheumatoid arthritis: evaluating the bidirectional association

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