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Multicenter Study
. 2020 Aug 1;59(8):2043-2051.
doi: 10.1093/rheumatology/kez562.

Hydroxychloroquine is associated with a lower risk of polyautoimmunity: data from the RELESSER Registry

Natalia Mena-Vázquez  1   2 , Antonio Fernández-Nebro  1   2   3 , José María Pego-Reigosa  4 , María Galindo  5 , Ana Melissa-Anzola  6 , Esther Uriarte-Isacelay  7 , Alejandro Olivé-Marqués  8 , Elena Aurrecoechea  9 , Mercedes Freire  10 , Eva Tomero  1 , María Jesús García-Villanueva  11 , Claudia Stoye  12 , Esteban Salas-Heredia  13 , Jose Antonio Bernal-Vidal  14 , Eva Salgado  15 , Ricardo Blanco  16 , Francisco Javier Novoa  17 , Mónica Ibáñez-Barcelo  18 , Vicente Torrente-Segarra  19 , Javier Narvaez  20 , Joan Calvet  21 , Clara Moriano Morales  22 , Tomas Ramon Vazquez-Rodriguez  23 , Paloma Garcia de la Peña  24 , Cristina Bohórquez  25 , José Luis Andreu-Sánchez  26 , Tatiana Cobo-Ibañez  27 , Gema Bonilla  28 , Nuria Lozano-Rivas  29 , Carlos Montilla  30 , Francisco Javier Toyos  31 , Jose Luis Marenco De la Fuente  32 , Lorena Expósito  33 , María Esther Ruiz-Lucea  34 , Elia Vals  35 , Javier Manero-Ruiz  36 , Jose A Bernal-Vidal  37 , Iñigo Rua-Figueroa  38
Affiliations
Multicenter Study

Hydroxychloroquine is associated with a lower risk of polyautoimmunity: data from the RELESSER Registry

Natalia Mena-Vázquez et al. Rheumatology (Oxford). .

Abstract

Objectives: This article estimates the frequency of polyautoimmunity and associated factors in a large retrospective cohort of patients with SLE.

Methods: RELESSER (Spanish Society of Rheumatology Lupus Registry) is a nationwide multicentre, hospital-based registry of SLE patients. This is a cross-sectional study. The main variable was polyautoimmunity, which was defined as the co-occurrence of SLE and another autoimmune disease, such as autoimmune thyroiditis, RA, scleroderma, inflammatory myopathy and MCTD. We also recorded the presence of multiple autoimmune syndrome, secondary SS, secondary APS and a family history of autoimmune disease. Multiple logistic regression analysis was performed to investigate possible risk factors for polyautoimmunity.

Results: Of the 3679 patients who fulfilled the criteria for SLE, 502 (13.6%) had polyautoimmunity. The most frequent types were autoimmune thyroiditis (7.9%), other systemic autoimmune diseases (6.2%), secondary SS (14.1%) and secondary APS (13.7%). Multiple autoimmune syndrome accounted for 10.2% of all cases of polyautoimmunity. A family history was recorded in 11.8%. According to the multivariate analysis, the factors associated with polyautoimmunity were female sex [odds ratio (95% CI), 1.72 (1.07, 2.72)], RP [1.63 (1.29, 2.05)], interstitial lung disease [3.35 (1.84, 6.01)], Jaccoud arthropathy [1.92 (1.40, 2.63)], anti-Ro/SSA and/or anti-La/SSB autoantibodies [2.03 (1.55, 2.67)], anti-RNP antibodies [1.48 (1.16, 1.90)], MTX [1.67 (1.26, 2.18)] and antimalarial drugs [0.50 (0.38, 0.67)].

Conclusion: Patients with SLE frequently present polyautoimmunity. We observed clinical and analytical characteristics associated with polyautoimmunity. Our finding that antimalarial drugs protected against polyautoimmunity should be verified in future studies.

Keywords: multiple autoimmune syndrome; polyautoimmunity; systemic lupus erythematosus.

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