Risk of Hidradenitis Suppurativa Comorbidities Over Time: A Prospective Cohort Study of Danish Blood Donors
DOI:
https://doi.org/10.2340/00015555-3737Keywords:
hidradenitis suppurativa, survival analysis, prescription, comorbidity, analgesia, antidepressantsAbstract
Hidradenitis suppurativa is a common recurrent inflammatory skin disease. It is associated with multiple comorbidities whose temporal relationships are unknown due to long diagnostic delays. This study of otherwise healthy blood donors with self-reported symptoms of hidradenitis suppurativa investigated the temporal relationships of comorbidities. A prospective survival analysis on a nationwide cohort of blood donors, using registry data on drug prescription, was used to calculate the hazard ratio of time until first prescription of medical treatment for the following hidradenitis suppurativa-related comorbidities: heart disease, diabetes, depression, thyroid disease and pain. Hidradenitis suppurativa status was determined by a validated questionnaire, and the survival analysis was adjusted for age, sex, body mass index, smoking status and having an International Classification of Diseases Version 10 (ICD-10) diagnosis of hidradenitis suppurativa. Of the participants, 1,012 reported hidradenitis suppurativa symptoms, and these symptoms increased the hazard ratio of antidepressants (1.73, 95% confidence interval 1.17–2.56, p ≈ 0.006) and analgesics (hazard ratio 1.24, 95% confidence interval 1.11–1.39, p < 0.001). Pain and depression are the first comorbidities to present in hidradenitis suppurativa pathogenesis.
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Ingram JR, Woo PN, Chua SL, Ormerod AD, Desai N, Kai AC, et al. Interventions for hidradenitis suppurativa: a Cochrane systematic review incorporating GRADE assessment of evidence quality. Br J Dermatol 2016; 174: 970-978.
DOI: https://doi.org/10.1111/bjd.14418
Theut Riis P, Pedersen OB, Sigsgaard V, Erikstrup C, Paarup HM, Nielsen KR, et al. Prevalence of patients with self-reported hidradenitis suppurativa in a cohort of Danish blood donors: a cross-sectional study. Br J Dermatol 2019; 180: 774-781.
DOI: https://doi.org/10.1111/bjd.16998
Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med 2012; 366: 158-164.
DOI: https://doi.org/10.1056/NEJMcp1014163
Zouboulis CC, Del Marmol V, Mrowietz U, Prens EP, Tzellos T, Jemec GB. Hidradenitis suppurativa/acne inversa: criteria for diagnosis, severity assessment, classification and disease evaluation. Dermatology 2015; 231: 184-190.
DOI: https://doi.org/10.1159/000431175
Clerc H, Tavernier E, Giraudeau B, Bourdais-Sallot A, Samimi M, Abdo I, et al. Understanding the long diagnostic delay for hidradenitis suppurativa: a national survey among French general practitioners. Eur J Dermatol 2019; 29: 97-99.
Tzellos T, Zouboulis CC, Gulliver W, Cohen AD, Wolkenstein P, Jemec GB. Cardiovascular disease risk factors in patients with hidradenitis suppurativa: a systematic review and meta-analysis of observational studies. Br J Dermatol 2015; 173: 1142-1155.
DOI: https://doi.org/10.1111/bjd.14024
Shavit E, Dreiher J, Freud T, Halevy S, Vinker S, Cohen AD. Psychiatric comorbidities in 3207 patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2015; 29: 371-376.
DOI: https://doi.org/10.1111/jdv.12567
Shalom G, Freud T, Ben Yakov G, Khoury R, Dreiher J, Vardy DA, et al. Hidradenitis suppurativa and inflammatory bowel disease: a cross-sectional study of 3,207 patients. J Invest Dermatol 2016; 136: 1716-1718.
DOI: https://doi.org/10.1016/j.jid.2016.04.003
Miller IM, Vinding G, Sorensen HA, Rytgaard H, Mogensen UB, Ellervik C, et al. Thyroid function in hidradenitis suppurativa: a population-based cross-sectional study from Denmark. Clin Exp Dermatol 2018; 43: 899-905.
DOI: https://doi.org/10.1111/ced.13606
Killasli H, Sartorius K, Emtestam L, Svensson Å. Hidradenitis suppurativa in Sweden: a registry-based cross-sectional study of 13,538 patients. Dermatology 2020; 236: 281-288.
DOI: https://doi.org/10.1159/000505545
Tzur Bitan D, Berzin D, Cohen A. Hidradenitis suppurativa and bipolar disorders: a population-based study. Dermatology 2020; 236: 298-304.
DOI: https://doi.org/10.1159/000504535
Garg A, Neuren E, Cha D, Kirby JS, Ingram JR, Jemec GBE, et al. Evaluating patients' unmet needs in hidradenitis suppurativa: results from the Global Survey Of Impact and Healthcare Needs (VOICE) Project. J Am Acad Dermatol 2020; 82: 366-376.
DOI: https://doi.org/10.1016/j.jaad.2019.06.1301
Saunte DM, Boer J, Stratigos A, Szepietowski JC, Hamzavi I, Kim KH, et al. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol 2015; 173: 1546-1549.
DOI: https://doi.org/10.1111/bjd.14038
Santos JV, Lisboa C, Lanna C, Costa-Pereira A, Freitas A. Is the prevalence of hidradenitis suppurativa being overestimated in Europe? Or is the disease underdiagnosed? Evidence from a nationwide study across Portuguese public hospitals. Int J Dermatol 2017; 56: 1491-1492.
DOI: https://doi.org/10.1111/ijd.13703
Kokolakis G, Wolk K, Schneider-Burrus S, Kalus S, Barbus S, Gomis-Kleindienst S, et al. Delayed diagnosis of hidradenitis suppurativa and its effect on patients and healthcare system. Dermatology 2020; 236: 421-430.
DOI: https://doi.org/10.1159/000508787
Vinding GR, Miller IM, Zarchi K, Ibler KS, Ellervik C, Jemec GB. The prevalence of inverse recurrent suppuration: a population-based study of possible hidradenitis suppurativa. Br J Dermatol 2014; 170: 884-889.
DOI: https://doi.org/10.1111/bjd.12787
Ullum H, Rostgaard K, Kamper-Jorgensen M, Reilly M, Melbye M, Nyren O, et al. Blood donation and blood donor mortality after adjustment for a healthy donor effect. Transfusion 2015; 55: 2479-2485.
DOI: https://doi.org/10.1111/trf.13205
Pedersen OB, Erikstrup C, Kotze SR, Sorensen E, Petersen MS, Grau K, et al. The Danish Blood Donor Study: a large, prospective cohort and biobank for medical research. Vox Sang 2012; 102: 271.
DOI: https://doi.org/10.1111/j.1423-0410.2011.01553.x
Kaspersen KA, Pedersen OB, Petersen MS, Hjalgrim H, Rostgaard K, Moller BK, et al. Obesity and risk of infection: results from the Danish Blood Donor Study. Epidemiology 2015; 26: 580-589.
DOI: https://doi.org/10.1097/EDE.0000000000000301
Hansen TF, Banasik K, Erikstrup C, Pedersen OB, Westergaard D, Chmura PJ, et al. DBDS Genomic Cohort, a prospective and comprehensive resource for integrative and temporal analysis of genetic, environmental and lifestyle factors affecting health of blood donors. BMJ Open 2019; 9: e028401.
DOI: https://doi.org/10.1136/bmjopen-2018-028401
Burgdorf KS, Felsted N, Mikkelsen S, Nielsen MH, Thorner LW, Pedersen OB, et al. Digital questionnaire platform in the Danish Blood Donor Study. Comput Methods Programs Biomed 2016; 135: 101-104.
DOI: https://doi.org/10.1016/j.cmpb.2016.07.023
Bech P, Rasmussen NA, Olsen LR, Noerholm V, Abildgaard W. The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Disord 2001; 66: 159-164.
DOI: https://doi.org/10.1016/S0165-0327(00)00309-8
Schmidt M, Schmidt SA, Sandegaard JL, Ehrenstein V, Pedersen L, Sorensen HT. The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 2015; 7: 449-490.
DOI: https://doi.org/10.2147/CLEP.S91125
Organization WH. ATC structure and principles. [accessed May 18, 2020]. Available from: https://www.whocc.no/atc/structure_and_principles/.
Wickham H. tidyverse: Easily Install and Load the 'Tidyverse' 2017 [cited 2019 Sept 24]. Available from: https://CRAN.R-projects.org/package=tidyverse.
Therneau TM. Grambsch PM. Modeling survival data: extending the Cox model. New York: Springer; 2000.
DOI: https://doi.org/10.1007/978-1-4757-3294-8
von der Werth JM, Jemec GB. Morbidity in patients with hidradenitis suppurativa. Br J Dermatol 2001; 144: 809-813.
DOI: https://doi.org/10.1046/j.1365-2133.2001.04137.x
Matusiak ?, Szcz?ch J, Kaaz K, Lelonek E, Szepietowski JC. Clinical characteristics of pruritus and pain in patients with hidradenitis suppurativa. Acta Derm Venereol 2018; 98: 191-194.
DOI: https://doi.org/10.2340/00015555-2815
Fernandez JM, Thompson AM, Borgstrom M, Orenstein LAV, Hsiao JL, Shi VY. Pain management modalities for hidradenitis suppurativa: a patient survey. J Dermatolog Treat 2020 Sep 20. [Online ahead of print].
DOI: https://doi.org/10.1080/09546634.2020.1822501
McMillan K. Hidradenitis suppurativa: number of diagnosed patients, demographic characteristics, and treatment patterns in the United States. Am J Epidemiol 2014; 179: 1477-1483.
DOI: https://doi.org/10.1093/aje/kwu078
World Health Organization (WHO). WHO guidelines for the management of cancer pain. [accessed May 18, 2020].Available from: https://www.who.int/ncds/management/palliative-care/Infographic-cancer-pain-lowres.pdf.
Garg A, Papagermanos V, Midura M, Strunk A, Merson J. Opioid, alcohol, and cannabis misuse among patients with hidradenitis suppurativa: a population-based analysis in the United States. J Am Acad Dermatol 2018; 79: 495-500.e491.
DOI: https://doi.org/10.1016/j.jaad.2018.02.053
Nielsen RM, Lindsø Andersen P, Sigsgaard V, Theut Riis P, Jemec GB. Pain perception in patients with hidradenitis suppurativa. Br J Dermatol 2020; 182: 166-174.
DOI: https://doi.org/10.1111/bjd.18656
Machado MO, Stergiopoulos V, Maes M, Kurdyak PA, Lin PY, Wang LJ, et al. Depression and anxiety in adults with hidradenitis suppurativa: a systematic review and meta-analysis. JAMA Dermatol 2019; 155: 939-945.
DOI: https://doi.org/10.1001/jamadermatol.2019.0759
Kjærsgaard Andersen R, Jørgensen IF, Reguant R, Jemec GBE, Brunak S. Disease trajectories for hidradenitis suppurativa in the Danish population. JAMA Dermatol 2020; 156: 780-786.
DOI: https://doi.org/10.1001/jamadermatol.2020.1281
Johannesdottir SA, Horváth-Puhó E, Ehrenstein V, Schmidt M, Pedersen L, Sørensen HT. Existing data sources for clinical epidemiology: the Danish National Database of Reimbursed Prescriptions. Clin Epidemiol 2012; 4: 303-313.
DOI: https://doi.org/10.2147/CLEP.S37587
Lepine JP, Briley M. The increasing burden of depression. Neuropsychiatr Dis Treat 2011; 7: 3-7.
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Copyright (c) 2021 Rune Kjærsgaard Andersen, Isabella Charlotte Loft, Kristoffer Burgdorf, Christian Erikstrup, Ole B. Pedersen, Gregor B.E. Jemec
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