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Patients with celiac disease more likely to develop lupus
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Patients with celiac disease had three times the risk for developing systemic lupus erythematosus compared with the general population, according to study data.
Researchers compared 29,048 patients (61.8% women) with biopsy-verified celiac disease (CD) from Sweden’s 28 pathology departments with 144,352 controls (61.9% women) from the general population identified in the Swedish Total Population Register. Two records or more of systemic lupus erythematosus (SLE) in the Swedish Patient Register were used as the disease benchmark. Hazard ratios for SLE were estimated using Cox regression.
Jonas F. Ludvigsson
The median age at first diagnosis for SLE was 52 years in the CD cohort and 48 years in the control cohort. Fifty-four patients (89% women) with CD had SLE during follow-up of 325,770 person-years (IR=17 cases/100,000 person-years) compared with 81 cases in the control cohort during 1,640,669 person-years (IR=5 cases/100,000 person-years), with an excess risk of 12/100,000 person-years (HR=3.49; 95% CI, 2.48-4.90). In the first year of follow-up, the CD cohort had eight times the risk for SLE (HR=8.85; 95% CI, 3.41-22.98). At 5 years, HR dropped to 2.54 (95% CI, 1.57-4.10). Similar risk estimates were found in men and women. With outcome restricted to patients who were dispensed medication for SLE, HR was 2.43 (95% CI, 1.22-4.87).
The threefold increased risk for patients with CE “still translates into a low absolute risk — we estimate that at most, two individuals with CD out of 1,000 would develop SLE in the 10 years following CD diagnosis,” the researchers said.
Clinicians might find the large number of patients in the study surprising, researcher Jonas F. Ludvigsson, MD, PhD, of the clinical epidemiology unit, department of medicine at Karolinska University Hospital and Karolinska Institutet in Stockholm, Sweden, told Healio.com. “The awareness of celiac disease is very high in Sweden, and our excellent nationwide registers enable us to keep track of patients with different diagnoses,” he said.
Disclosure: See the study for a full list of relevant disclosures.
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