Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 10:8:654791.
doi: 10.3389/fmed.2021.654791. eCollection 2021.

Risk of Systemic Lupus Erythematosus in Patients With Anti-phospholipid Syndrome: A Population-Based Study

Hsin-Hua Chen  1   2   3   4   5 , Ching-Heng Lin  1   4   6   7 , Wen-Cheng Chao  8   9   10
Affiliations

Risk of Systemic Lupus Erythematosus in Patients With Anti-phospholipid Syndrome: A Population-Based Study

Hsin-Hua Chen et al. Front Med (Lausanne). .

Abstract

Objective: To investigate the association between anti-phospholipid syndrome (APS) and the risk of newly diagnosed systemic lupus erythematosus (SLE). Methods: We used 2003-2013 data derived from Taiwan's National Health Insurance Research Database to conduct this nationwide, population-based. We identified AS patients newly diagnosed between 2005 to 2013 as the study group and applied age-sex matched (1:20) and propensity score-matched (PSM) (1:2) non-SLE individuals as controls. The association between APS and risk of incident SLE was determined by calculating hazard ratios (HRs) with 95% confidence intervals (CIs) using Cox proportional hazard regression analysis. Results: We identified 1,245 patients with APS as well as 24,900 age- and sex-matched non-APS controls and 727 APS patients as well as 1,454 PSM non-APS controls. We found that the risk for incident SLE in the APS group was 80.70 times higher than the non-APS group, and the association remained robust after PSM (HR, 28.55; 95% CI, 11.49-70.91). The increased risk for SLE in patients with APS mainly existed within 5 years after the diagnosis of APS. The sensitivity analyses found that the risk for SLE in patients with APS was consistent excluding patients with ITP/AIHA and using distinct definitions of SLE. Conclusion: The present population-based study revealed a robust association between SLE risk and recent APS and highlights the need for vigilance of SLE-associated symptoms in patients who had been diagnosed with APS.

Keywords: anti-phospholipid syndrome; autoimmune diseases; propensity matching; risk; systemic lupus erythematosus.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study design. APS, anti-phospholipid syndrome; SLE, systemic lupus erythematosus; PSM, propensity score matching.
Figure 2
Figure 2
The cumulative incidence of SLE for patients with and without APS. (A) age- and sex-matched population. (B) Propensity score-matched population. APS, anti-phospholipid syndrome; SLE, systemic lupus erythematosus.
See this image and copyright information in PMC

References

    1. Zhu FX, Huang JY, Ye Z, Wen QQ, Wei JC. Risk of systemic lupus erythematosus in patients with idiopathic thrombocytopenic purpura: a population-based cohort study. Ann Rheum Dis. (2020) 79:793–99. 10.1136/annrheumdis-2020-217013 - DOI - PubMed
    1. Mo HY, Wei JCC, Chen XH, Chen HH. Increased risk of systemic lupus erythematosus in patients with autoimmune haemolytic anaemia: a nationwide population-based cohort study. Ann Rheum Dis. (2020) 80:403–4. 10.1136/annrheumdis-2020-219328 - DOI - PubMed
    1. Tincani A, Andreoli L, Chighizola C, Meroni PL. The interplay between the antiphospholipid syndrome and systemic lupus erythematosus. Autoimmunity. (2009) 42:257–9. 10.1080/08916930902827918 - DOI - PubMed
    1. Belizna C, Stojanovich L, Cohen-Tervaert JW, Fassot C, Henrion D, Loufrani L, et al. . Primary antiphospholipid syndrome and antiphospholipid syndrome associated to systemic lupus: are they different entities? Autoimmun Rev. (2018) 17:739–45. 10.1016/j.autrev.2018.01.027 - DOI - PubMed
    1. Shoenfeld Y, Meroni PL, Toubi E. Antiphospholipid syndrome and systemic lupus erythematosus: are they separate entities or just clinical presentations on the same scale? Curr Opin Rheumatol. (2009) 21:495–500. 10.1097/BOR.0b013e32832effdd - DOI - PubMed