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HS patients carry higher risk for systemic lupus erythematosus

AAD 2020
phase 1
A US cohort study showed a greater likelihood of developing certain connective tissue diseases like morphoea or systemic lupus erythematosus (SLE) in patients already suffering from hidradenitis suppurativa (HS) [1,2].

Associations between HS and various autoimmune conditions including inflammatory bowel diseases or spondyloarthropathies have been reported in the past. A new population-based study focused on the possibility that HS may also be linked to autoimmune pathologies of connective tissue disease (CTD). Data was retrieved from claims files of non-governmental health insurance from 31 December 2002 to 31 December 2017 in the USA. Included were patients with a diagnosis of HS that were compared with a group of non-HS patients with similar risk profiles and comorbidity. The study population included 66,448 patients with and without HS with a mean age of 37 years. About 3 quarters of patients were female, and comorbidities in terms of IBD, psoriasis, or arthritis ranged between 0.7% and 1.2% with a similar distribution of diagnoses in both groups. The median follow-up time was 533 days in the HS group and 545 days in the non-HS group. Follow-up was terminated in case of a first event of new diagnosis of CTD, death, disenrollment, or end of data stream. Non-biologic immune-modulatory treatment was taken by 1.4% in both groups, and biologics were prescribed to 0.9% of patients in the HS group and 0.6% in the non-HS group.

Hazard ratios (HR) for developing systemic sclerosis (HR 0.9), systemic vasculitis (HR 0.87) or Sjögren’s syndrome (HR 0.9) were not elevated. However, a substantial association was found for HS and SLE (HR 1.63). The risk of being diagnosed with morphoea when suffering from HS was doubled (HR 2.02) compared with a patient with a comparable risk profile without HS. The investigators deemed it most likely that SLE was newly appearing instead of already co-existing, as a Kaplan-Meier analysis discovered a maintained relationship between HS and SLE.

  1. Schneeweiss MC, et al. P18695, AAD Virtual Meeting Experience, 12-14 June 2020.
  2. Schneeweiss MC, et al. J Eur Acad Dermatol Venereol. June 2020. Doi:10.1111/jdv.16728.

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