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

Christoffer S Graven-Nielsen; Ida V Vittrup; Anna J Kragh; Fredrik Lund; Sofie Bliddal; Kristian Kofoed; Salome Kristensen; Allan Stensballe; Claus H Nielsen; Ulla Feldt-Rasmussen; René Cordtz; Lene Dreyer

doi:10.1016/j.jdin.2023.07.018

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

Christoffer S Graven-Nielsen^*, Ida V Vittrup, Anna J Kragh, Fredrik Lund, Sofie Bliddal, Kristian Kofoed, Salome Kristensen, Allan Stensballe, Claus H Nielsen, Ulla Feldt-Rasmussen, René Cordtz, Lene Dreyer

^*Corresponding author for this work

Department for Rheumatology and Spine Diseases

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.

Original language	English
Journal	JAAD International
Volume	13
Pages (from-to)	126-133
Number of pages	8
DOIs	https://doi.org/10.1016/j.jdin.2023.07.018
Publication status	Published - Dec 2023

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Graven-Nielsen, C. S., Vittrup, I. V., Kragh, A. J., Lund, F., Bliddal, S., Kofoed, K., Kristensen, S., Stensballe, A., Nielsen, C. H., Feldt-Rasmussen, U., Cordtz, R., & Dreyer, L. (2023). Polyautoimmunity in patients with cutaneous lupus erythematosus: A nationwide sex- and age-matched cohort study from Denmark. JAAD International, 13, 126-133. https://doi.org/10.1016/j.jdin.2023.07.018

Graven-Nielsen, CS, Vittrup, IV, Kragh, AJ, Lund, F, Bliddal, S, Kofoed, K, Kristensen, S, Stensballe, A, Nielsen, CH , Feldt-Rasmussen, U , Cordtz, R & Dreyer, L 2023, 'Polyautoimmunity in patients with cutaneous lupus erythematosus: A nationwide sex- and age-matched cohort study from Denmark', JAAD International, vol. 13, pp. 126-133. https://doi.org/10.1016/j.jdin.2023.07.018

@article{b15301c2e6664470a4772d296b77a3eb,

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

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.",

author = "Graven-Nielsen, {Christoffer S} and Vittrup, {Ida V} and Kragh, {Anna J} and Fredrik Lund and Sofie Bliddal and Kristian Kofoed and Salome Kristensen and Allan Stensballe and Nielsen, {Claus H} and Ulla Feldt-Rasmussen and Ren{\'e} Cordtz and Lene Dreyer",

note = "{\textcopyright} 2023 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.",

year = "2023",

month = dec,

doi = "10.1016/j.jdin.2023.07.018",

language = "English",

volume = "13",

pages = "126--133",

journal = "JAAD International",

issn = "2666-3287",

publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Polyautoimmunity in patients with cutaneous lupus erythematosus

T2 - A nationwide sex- and age-matched cohort study from Denmark

AU - Graven-Nielsen, Christoffer S

AU - Vittrup, Ida V

AU - Kragh, Anna J

AU - Lund, Fredrik

AU - Bliddal, Sofie

AU - Kofoed, Kristian

AU - Kristensen, Salome

AU - Stensballe, Allan

AU - Nielsen, Claus H

AU - Feldt-Rasmussen, Ulla

AU - Cordtz, René

AU - Dreyer, Lene

PY - 2023/12

Y1 - 2023/12

N2 - 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.

AB - 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.

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U2 - 10.1016/j.jdin.2023.07.018

DO - 10.1016/j.jdin.2023.07.018

M3 - Journal article

C2 - 37808964

SN - 2666-3287

VL - 13

SP - 126

EP - 133

JO - JAAD International

JF - JAAD International

ER -

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

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