Risk of Autoimmune Diseases Following Optic Neuritis: A Nationwide Population-Based Cohort Study

Frontiers in Medicine

article

Wen Jie Zheng¹  Kevin Sheng-Kai Ma¹  Chee-Ming Lee⁵  Po-Hung Chen⁶  Yan Yang⁸  Yi Wei Dong¹  Yu-Hsun Wang⁹  James Cheng-Chung Wei⁶ 

[1] Department of Pediatrics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University;Center for Global Health, Perelman School of Medicine, University of Pennsylvania;Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University;Department of Epidemiology, Harvard T.H. Chan School of Public Health;Department of Ophthalmology, Jen-Ai Hospital;Institute of Medicine, Chung Shan Medical University;Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu;Department of Ultrasound, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University;Department of Medical Research, Chung Shan Medical University Hospital;Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital;Graduate Institute of Integrated Medicine, China Medical University

关键词: cohort study;    ankylosing spondylitis;    rheumatoid arthritis;    systemic lupus erythematosus;    psoriatic arthritis;    myasthenia gravis;    autoimmune diseases;    optic neuritis;   

DOI  :  10.3389/fmed.2022.903608

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objectives Optic neuritis is (ON) is believed to be an immune-mediated disease; however, the association between optic neuritis and autoimmune diseases remains unclear. This study aimed to identify the incidence rate and adjusted hazard ratio (aHR) of autoimmune diseases in patients with optic neuritis. Methods This nationwide, population-based, retrospective cohort study collected patients’ data between 1999 and 2013 from the National Health Insurance Research Database in Taiwan. A total of 9,235 patients were included. Using 1:4 propensity scoring, 1,847 patients were enrolled in the optic neuritis group and 7,388 in the non-optic neuritis group according to age, sex, comorbidities, and corticosteroid use. Follow-up was started from the index date and the endpoint was a diagnosis of new-onset autoimmune diseases including, myasthenia gravis (MG), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and ankylosing spondylitis (AS). Results The Kaplan-Meier curves depicted that patients with optic neuritis had a higher cumulative incidence of autoimmune diseases than patients without optic neuritis. Cox proportional hazard regression showed that patients with optic neuritis were at a high risk of autoimmune diseases (aHR: 1.40; 95% C.I., 1.05–1.87), including MG (aHR: 4.16, 95% C.I.: 1.33–12.94), SLE (aHR: 3.33, 95% C.I.: 1.24–8.97), and AS (aHR: 2.86, 95% C.I.: 1.54–5.31). Subgroup analysis provided that patients with optic neuritis aged below 65 years (aHR: 1.42, 95% C.I.: 1.03–1.96) or who were females (aHR: 1.59, 95% C.I.: 1.11–2.27) had a significantly increased risk of autoimmune diseases compared to respective controls. The use of corticosteroids reduced the risk of autoimmune diseases in patients with optic neuritis (aHR for corticosteroids non-users: 1.46, 95% C.I.: 1.03–2.07). Conclusion Patients with optic neuritis presented with a high risk of autoimmune diseases such as MG, SLE, and AS, especially patients with optic neuritis who were young or females. Corticosteroids attenuated the link between optic neuritis and subsequent autoimmune diseases.

【 授权许可】

CC BY