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. 2023 Aug 25:13:126-133.
doi: 10.1016/j.jdin.2023.07.018. eCollection 2023 Dec.

Polyautoimmunity in patients with cutaneous lupus erythematosus: A nationwide sex- and age-matched cohort study from Denmark

Christoffer S Graven-Nielsen  1 , Ida V Vittrup  1 , Anna J Kragh  1 , Fredrik Lund  1 , Sofie Bliddal  2   3 , Kristian Kofoed  4 , Salome Kristensen  1   5 , Allan Stensballe  6   7 , Claus H Nielsen  3 , Ulla Feldt-Rasmussen  2   8 , René Cordtz  1 , Lene Dreyer  1   5
Affiliations

Polyautoimmunity in patients with cutaneous lupus erythematosus: A nationwide sex- and age-matched cohort study from Denmark

Christoffer S Graven-Nielsen et al. JAAD Int. .

Abstract

Background: Polyautoimmunity is defined as having 2 or more autoimmune diseases. Little is known about polyautoimmunity in patients with cutaneous lupus erythematosus (CLE).

Objectives: To estimate prevalence and 5-year incidence of non-lupus erythematosus (LE) autoimmune diseases in patients with CLE.

Methods: Patients with CLE were identified In the Danish National Patient Registry and each patient was age- and sex-matched with 10 general population controls. Outcome information on non-LE autoimmune diseases was obtained by register-linkage between Danish National Patient Registry and the National Prescription Register. The risk ratio (RR) for prevalent non-LE autoimmune disease at time of CLE diagnosis was calculated in modified Poisson regression; and hazard ratios (HRs) for incident non-LE autoimmune disease were estimated in Cox regression analyses.

Results: Overall, 1674 patients with CLE had a higher prevalence of a non-LE autoimmune disease than the comparators (18.5 vs 7.9%; RR 2.4; 95% CI, 2.1 to 2.6). Correspondingly, the cumulative incidence of a non-LE autoimmune disease during 5 years of follow-up was increased for the patients with CLE: HR 3.5 (95% CI, 3.0 to 4.0).

Limitations: Risk of detection and misclassification bias, mainly pertaining to the CLE group.

Conclusion: Patients with CLE had higher prevalence and 5-year cumulative incidence of a non-LE autoimmune disease than the general population.

Keywords: autoimmune diseases; cutaneous lupus erythematosus; epidemiology; polyautoimmunity; thyroid autoimmunity.

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Conflict of interest statement

Dr Cordtz is employed at IQVIA outside of this work. Dr Dreyer has received speakers fee from Eli Lilly, Galderma, and Janssen and research grants from BMS (outside the present work). Drs Kofoed, Stensballe, Bliddal, Kristensen, Feldt-Rasmussen, and Nielsen and Authors Graven-Nielsen, Vittrup, Kragh, and Lund have no conflicts of interest to declare.

Figures

Fig 1
Fig 1
The 5-year cumulative incidence of being diagnosed with an additional autoimmune disease in patients with cutaneous lupus erythematosus and matched controls based on the Aalen-Johansen estimator.
See this image and copyright information in PMC

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