Journal
RHEUMATOLOGY
Volume 61, Issue 3, Pages 1123-1132Publisher
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/keab502
Keywords
macrophage activation syndrome; SLE; autoimmune disease; NHIRD
Categories
Funding
- Taichung Veterans General Hospital [TCVGH-1097321D]
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This study aimed to determine the bidirectional relationship between macrophage activation syndrome (MAS) and systemic lupus erythematosus (SLE). The results showed that there was no significant association between a history of MAS and the risk of SLE, but the risk of MAS was markedly increased in patients with SLE.
Objectives 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.
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