Chang Hui-Chin, Chang Chia-Chi, Chu Yen-Ju, Hsu Wei-Ting, Li Yun-Feng, Jhang Yi-Sheng, Su Yu-Jung, Chen Shiu-Jau, Zuberbier Torsten, Gau Shuo-Yan
Evidence-based Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan; Library, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Acta Derm Venereol. 2025 Sep 4;105:adv43515. doi: 10.2340/actadv.v105.43515.
Prurigo nodularis (PN) has been associated with autoimmune diseases, though longitudinal data are limited. This study investigates the risk of autoimmune disease development in PN patients using a global electronic health record database. This retrospective cohort study analysed data from the Global Collaborative Network within the TriNetX research network. Adults (≥ 18 years) with PN were compared with propensity score-matched controls without PN. Matching considered age, sex, comorbidities, race, and socioeconomic status. Patients with prior autoimmune diseases or cancers were excluded. Incident autoimmune diseases, including systemic lupus erythematosus (SLE), Sjögren's syndrome, psoriasis, ankylosing spondylitis (AS), rheumatoid arthritis (RA), Crohn's disease (CD), and ulcerative colitis (UC), were evaluated using hazard ratios (HR). Among 17,963 PN patients and the same amount of matched pairs, PN patients had higher risks for SLE (HR: 2.16, 95% CI: 1.44-3.24), Sjögren's syndrome (HR: 1.86, 95% CI: 1.33-2.59), and psoriasis (HR: 3.20, 95% CI: 2.58-3.97). Stratified analysis revealed that female PN patients had higher risks for SLE and Sjögren's syndrome, while psoriasis risk was elevated in both sexes, especially in males. Risks for AS, RA, CD, and UC were not significant. Sensitivity analyses validated these findings. In conclusion, PN is linked to increased risks for SLE, Sjögren's syndrome, and psoriasis, highlighting the need for proactive screening and management of autoimmune diseases in PN patients.
结节性痒疹（PN）与自身免疫性疾病有关，尽管纵向数据有限。本研究使用全球电子健康记录数据库调查PN患者发生自身免疫性疾病的风险。这项回顾性队列研究分析了TriNetX研究网络内全球协作网络的数据。将患有PN的成年人（≥18岁）与倾向评分匹配的无PN对照进行比较。匹配时考虑了年龄、性别、合并症、种族和社会经济地位。排除既往患有自身免疫性疾病或癌症的患者。使用风险比（HR）评估包括系统性红斑狼疮（SLE）、干燥综合征、银屑病、强直性脊柱炎（AS）、类风湿关节炎（RA）、克罗恩病（CD）和溃疡性结肠炎（UC）在内的新发自身免疫性疾病。在17963例PN患者和相同数量的匹配对照中，PN患者患SLE（HR：2.16，95%CI：1.44 - 3.24）、干燥综合征（HR：1.86，95%CI：1.33 - 2.59）和银屑病（HR：3.20，95%CI：2.58 - 3.97）的风险更高。分层分析显示，女性PN患者患SLE和干燥综合征的风险更高，而银屑病风险在两性中均升高，尤其是男性。AS、RA、CD和UC的风险不显著。敏感性分析验证了这些发现。总之，PN与SLE、干燥综合征和银屑病风险增加有关，凸显了对PN患者进行自身免疫性疾病主动筛查和管理的必要性。
