TY - JOUR
T1 - Bidirectional association between systemic lupus erythematosus and macrophage activation syndrome
T2 - A nationwide population-based study
AU - Huang, Lu Wei
AU - Wei, James Cheng Chung
AU - Chen, Der Yuan
AU - Chen, Yen Ju
AU - Tang, Kuo Tung
AU - Ko, Tai-Ming
AU - Chen, Hsin Hua
N1 - Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - To determine the bidirectional relationship between macrophage activation syndrome (MAS) and SLE. Methods: Using the 1997-2013 Taiwan National Health Insurance Research Database, we identified patients with newly diagnosed SLE from 2001 to 2013 and selected individuals without SLE from a 1 million representative population. Propensity score (PS) matching was performed to balance incident SLE patients and individuals without SLE according to age, sex, comorbidities and medical utilization. The association between a history of MAS and SLE was studied using conditional logistic regression analysis shown as an adjusted odds ratio (aOR). The risk of MAS associated with SLE was analysed using Cox proportional regression analysis, shown as an adjusted hazard ratio (aHR), and we conducted a sensitivity analysis using various definitions of MAS. Results: We included 10 481 SLE patients and 20 962 PS-matched (1:2) non-SLE individuals. The correlation between a history of MAS and SLE did not reach statistical significance after adjustment for potential confounders [aOR 1.18 (95% CI, 0.80, 1.75)] in the age-/sex-matched populations. In the 1:2 PS-matched populations, the risk of MAS markedly increased in patients with SLE [aHR 7.18 (95% CI 4.97, 10.36)]. Other risk factors for MAS included female gender, age ≥65 years, low income, a history of inflammatory bowel disease and a history of MAS. Conclusion: This nationwide, population-based study revealed that a history of MAS was not significantly associated with SLE risk. However, the risk of MAS was markedly associated with SLE and a history of MAS.
AB - To determine the bidirectional relationship between macrophage activation syndrome (MAS) and SLE. Methods: Using the 1997-2013 Taiwan National Health Insurance Research Database, we identified patients with newly diagnosed SLE from 2001 to 2013 and selected individuals without SLE from a 1 million representative population. Propensity score (PS) matching was performed to balance incident SLE patients and individuals without SLE according to age, sex, comorbidities and medical utilization. The association between a history of MAS and SLE was studied using conditional logistic regression analysis shown as an adjusted odds ratio (aOR). The risk of MAS associated with SLE was analysed using Cox proportional regression analysis, shown as an adjusted hazard ratio (aHR), and we conducted a sensitivity analysis using various definitions of MAS. Results: We included 10 481 SLE patients and 20 962 PS-matched (1:2) non-SLE individuals. The correlation between a history of MAS and SLE did not reach statistical significance after adjustment for potential confounders [aOR 1.18 (95% CI, 0.80, 1.75)] in the age-/sex-matched populations. In the 1:2 PS-matched populations, the risk of MAS markedly increased in patients with SLE [aHR 7.18 (95% CI 4.97, 10.36)]. Other risk factors for MAS included female gender, age ≥65 years, low income, a history of inflammatory bowel disease and a history of MAS. Conclusion: This nationwide, population-based study revealed that a history of MAS was not significantly associated with SLE risk. However, the risk of MAS was markedly associated with SLE and a history of MAS.
KW - autoimmune disease
KW - macrophage activation syndrome
KW - NHIRD
KW - SLE
UR - http://www.scopus.com/inward/record.url?scp=85125553184&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/keab502
DO - 10.1093/rheumatology/keab502
M3 - Article
C2 - 34146089
AN - SCOPUS:85125553184
SN - 1462-0324
VL - 61
SP - 1123
EP - 1132
JO - Rheumatology (Oxford, England)
JF - Rheumatology (Oxford, England)
IS - 3
ER -