C T Chen1,2, H Y Hu3,4, Y T Chang1,2, C P Li2,5, C Y Wu1,2,3. 1. Department of Dermatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 2. Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 3. National Yang-Ming University School of Medicine, Taipei, Taiwan. 4. Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan. 5. Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: Bullous pemphigoid (BP) is the most common autoimmune bullous disease. Whether there is an increased risk for subsequent BP among patients with cancer is still unclear. OBJECTIVES: To evaluate the risk for subsequent BP in patients with cancer. METHODS: This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database between 2000 and 2011. A total of 36 838 patients with cancer and 147 352 age-, sex- and index-date-matched controls were recruited. The hazard ratio (HR) of subsequent BP in the patients with cancer was analysed using a Fine-Gray competing risk regression model with mortality as the competing event. RESULTS: The incidence of BP per 100 000 person-years was 17·2 in the patients with cancer and 19·8 in the controls; therefore, the crude incidence rate ratio was 0·87 [95% confidence interval (CI) 0·53-1·36]. The HR of subsequent BP in the patients with cancer was 0·47 (95% CI 0·23-0·94) using the Fine-Gray competing risk regression model. Age (HR 1·05, 95% CI 1·03-1·07), diabetes mellitus (HR 1·69, 95% CI 1·10-2·59) and cerebrovascular disease (HR 2·14, 95% CI 1·36-3·34) were independent risk factors for BP. CONCLUSIONS: The incidence of BP in patients with cancer was not higher than in the control group. Cancer is not a risk factor for BP.
BACKGROUND: Bullous pemphigoid (BP) is the most common autoimmune bullous disease. Whether there is an increased risk for subsequent BP among patients with cancer is still unclear. OBJECTIVES: To evaluate the risk for subsequent BP in patients with cancer. METHODS: This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database between 2000 and 2011. A total of 36 838 patients with cancer and 147 352 age-, sex- and index-date-matched controls were recruited. The hazard ratio (HR) of subsequent BP in the patients with cancer was analysed using a Fine-Gray competing risk regression model with mortality as the competing event. RESULTS: The incidence of BP per 100 000 person-years was 17·2 in the patients with cancer and 19·8 in the controls; therefore, the crude incidence rate ratio was 0·87 [95% confidence interval (CI) 0·53-1·36]. The HR of subsequent BP in the patients with cancer was 0·47 (95% CI 0·23-0·94) using the Fine-Gray competing risk regression model. Age (HR 1·05, 95% CI 1·03-1·07), diabetes mellitus (HR 1·69, 95% CI 1·10-2·59) and cerebrovascular disease (HR 2·14, 95% CI 1·36-3·34) were independent risk factors for BP. CONCLUSIONS: The incidence of BP in patients with cancer was not higher than in the control group. Cancer is not a risk factor for BP.
Authors: Evelyn Wang; Lukas Kraehenbuehl; Kwami Ketosugbo; Jeffrey A Kern; Mario E Lacouture; Donald Y M Leung Journal: Ann Allergy Asthma Immunol Date: 2021-02-17 Impact factor: 6.248