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Risk of Developing Additional Immune-Mediated Manifestations: A Retrospective Matched Cohort Study
Daniel Aletaha1, Andrew J Epstein2, Martha Skup3
1Medical University of Vienna, Vienna, Austria. daniel.aletaha@meduniwien.ac.at.
Individuals with an initial immune-mediated inflammatory disease (IMID) diagnosis face a significantly higher risk of developing subsequent IMIDs. This highlights the importance of considering a patient's IMID history when planning treatment strategies.
Area of Science:
- Immunology
- Rheumatology
- Epidemiology
Background:
- Immune-mediated inflammatory diseases (IMIDs) significantly impact quality of life.
- Shared risk factors and mechanisms exist across IMIDs, yet data on subsequent IMID development is limited.
Purpose of the Study:
- To assess the risk of developing secondary IMIDs in patients with an initial IMID diagnosis.
Main Methods:
- Retrospective cohort study using a large US commercial health insurance claims database (2006-2015).
- Compared risk of secondary IMIDs in patients aged 18-64 with one of nine index IMIDs against matched controls.
- Utilized Cox proportional hazards models for risk assessment.
Main Results:
- Patients with an initial IMID had significantly higher risks of developing any one or any two secondary IMIDs compared to controls.
- Hazard ratios for any one secondary IMID ranged from 5.4 (hidradenitis suppurativa) to 62.2 (psoriatic arthritis).
- Hazard ratios for any two secondary IMIDs ranged from 3.0 (hidradenitis suppurativa) to 75.2 (psoriatic arthritis).
Conclusions:
- Individuals with a first IMID have a substantially elevated risk of developing a second IMID.
- Certain IMID pairs demonstrate higher co-occurrence rates.
- Understanding this elevated risk is crucial for clinical decision-making and treatment selection.
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