Faden Daniella F, Stone Caroline J, Xie Lillian, Lopes Almeida Gomes Lais, Werth Victoria P
Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
University of Pennsylvania, Philadelphia, PA, USA.
ACR Open Rheumatol. 2024 Dec;6(12):820-825. doi: 10.1002/acr2.11735. Epub 2024 Sep 4.
We assess the prevalence and patterns of herbal supplement treatment among patients with autoimmune skin diseases, particularly dermatomyositis (DM) and cutaneous lupus erythematosus (CLE), and identify commonly taken supplements and their associated risks.
This study screened 673 adult patients with clinicopathologic evidence of DM or CLE at the University of Pennsylvania's rheumatologic-dermatology clinic between January 2007 and February 2024. Demographic data, disease characteristics, and detailed information on herbal supplement treatment were collected. Predictors of supplement treatment were analyzed using chi-square tests and reported as odds ratios.
The prevalence of herbal supplement treatment was 32% among the cohort. The relative frequency of herbal supplement treatment was significantly higher in younger patients (44% of patients ages 18-29 years, reference; 29% ages 50-64 years, P = 0.02; 23% ages ≥65 years, P = 0.003) and in Hispanic/Latino patients (58% vs 31% White, P = 0.009). No significant difference in herbal supplement treatment was seen by sex (33% of female participants, 29% of male participants, P = 0.49), race (31% White, P = reference; 31% Black, P = 1.0; 38% Asian, P = 0.55), or disease (30% of patients with DM, 36% of patients with CLE; P = 0.12). Among patients with DM, 31% experienced a disease onset or exacerbation after supplement treatment compared with 10% of patients with CLE. Elderberry treatment was associated with the highest risk of exacerbation in both disease cohorts (62% DM, 50% CLE).
Herbal supplement treatment is prevalent among patients with autoimmune skin diseases, with immunostimulatory supplements posing a significant risk for immune dysregulation, particularly in DM. Providers should proactively screen and counsel patients regarding treatment with these supplements.
我们评估自身免疫性皮肤病患者，尤其是皮肌炎（DM）和皮肤红斑狼疮（CLE）患者中草药补充剂治疗的患病率和模式，并确定常用的补充剂及其相关风险。
本研究在2007年1月至2024年2月期间，对宾夕法尼亚大学风湿皮肤科诊所673例有DM或CLE临床病理证据的成年患者进行了筛查。收集了人口统计学数据、疾病特征以及草药补充剂治疗的详细信息。使用卡方检验分析补充剂治疗的预测因素，并以比值比报告。
该队列中草药补充剂治疗的患病率为32%。年轻患者（18至29岁患者的44%为参考值；50至64岁患者为29%，P = 0.02；≥65岁患者为23%，P = 0.003）和西班牙裔/拉丁裔患者（58%对白人的31%，P = 0.009）中，草药补充剂治疗的相对频率显著更高。在性别（女性参与者的33%，男性参与者的29%，P = 0.49）、种族（白人31%，P =参考值；黑人31%，P = 1.0；亚洲人38%，P = 0.55）或疾病（DM患者的30%，CLE患者的36%；P = 0.12）方面，草药补充剂治疗未见显著差异。在DM患者中，31%在补充剂治疗后出现疾病发作或加重，而CLE患者为10%。接骨木治疗在两个疾病队列中与加重风险最高相关（DM为62%，CLE为50%）。
草药补充剂治疗在自身免疫性皮肤病患者中很普遍，免疫刺激补充剂对免疫失调构成重大风险，尤其是在DM中。医疗服务提供者应主动筛查并就这些补充剂的治疗向患者提供咨询。
