Patients with pemphigus are at an increased risk of developing rheumatoid arthritis: a large-scale cohort study

Khalaf Kridin, Virginia A. Jones, Payal M. Patel, Shira Zelber-Sagi, Christoph M. Hammers, Giovanni Damiani, Kyle T. Amber, Arnon D. Cohen

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Data regarding the association between pemphigus and rheumatoid arthritis (RA) is inconclusive and yet to be firmly established. In the current study, we aimed to evaluate the risk of developing RA during the course of pemphigus. A large-scale population-based longitudinal cohort study was conducted to evaluate the hazard ratio (HR) of RA among 1985 patients with pemphigus relative to 9874 age-, sex-, and ethnicity-matched control subjects. A multivariate Cox regression model was utilized. The incidence of RA was 1.07 (95% CI, 0.62–1.72) and 0.36 (95% CI, 0.24–0.52) per 1000 person-years among patients with pemphigus and controls, respectively. The lifetime prevalence of RA was 2.3% (95% CI, 1.7–3.1%) among cases and 1.8% (95% CI, 1.5–2.0%) among controls. Patients with pemphigus were more than twice as likely to develop RA as compared to control subjects (adjusted HR, 2.54; 95% confidence interval [CI], 1.31–4.92). The increased risk was robust to a sensitivity analysis that included only cases managed by pemphigus-related systemic medications (adjusted HR, 2.56; 95% CI, 1.30–5.05). In conclusion, pemphigus is associated with an increased risk of RA. Physicians treating patients with pemphigus should be aware of this possible association. Further research is required to better understand the mechanism underlying this association.

Original languageEnglish
Pages (from-to)373-378
Number of pages6
JournalImmunologic Research
Issue number6
StatePublished - Dec 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020, The Author(s).


FundersFunder number
Universität zu Lübeck


    • Cohort study
    • Pemphigus
    • Rheumatoid arthritis


    Dive into the research topics of 'Patients with pemphigus are at an increased risk of developing rheumatoid arthritis: a large-scale cohort study'. Together they form a unique fingerprint.

    Cite this