Associations among bullous pemphigoid and various neurological diseases: A systematic review and meta‐analysis

Chen, Qianqian; Wu, Huangshuai; Lyu, Yansi; Xiong, Juan

doi:10.1002/jvc2.36

Cited by 4 publications

(5 citation statements)

References 42 publications

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“…Similarly, in a study including a larger sample of BP patients, Khosravani et al reported no difference between BP patients and controls in terms of MS. Nevertheless, MS has been linked to BP in multiple studies 16,18,22,24 . On the other hand, the risk of Parkinson's disease appears to be higher in BP patients, 22 yet we were not able to evaluate its pattern in our study.…”

Section: Discussionmentioning

confidence: 71%

“…Nevertheless, MS has been linked to BP in multiple studies 16,18,22,24 . On the other hand, the risk of Parkinson's disease appears to be higher in BP patients, 22 yet we were not able to evaluate its pattern in our study.…”

Section: Discussionmentioning

confidence: 71%

“…In the most recent systematic review and meta-analysis by Chen et al, the odds of Alzheimer's disease was 2.3 in BP patients compared to controls. 22 disease between BP patients and controls. 19 We found no MRI MS patterns in BP patients and controls.…”

Section: Discussionmentioning

confidence: 96%

“…There are contradictory results in terms of the association between BP and Alzheimer's disease in the literature. In the most recent systematic review and meta‐analysis by Chen et al, the odds of Alzheimer's disease was 2.3 in BP patients compared to controls 22 . Conversely, Papakonstantinou et al reported a lower prevalence of Alzheimer's disease in BP patients in comparison with the control group 23 .…”

Section: Discussionmentioning

confidence: 99%

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Brain MRI findings in patients with bullous pemphigoid: A case–control study

Ganji

Mahboubi-Fooladi

Shahidi‐Dadras

et al. 2023

Experimental Dermatology

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Evidence suggests that bullous pemphigoid (BP) is associated with multiple neurological disorders. We aimed to compare brain magnetic resonance (MRI) findings between BP patients and a control group. This case-control study included patients with BP referred to two dermatology clinics during a two-year period. A group of individuals attending the same clinics for cosmetic procedures were selected as controls. First, participants' general information including age, gender, education, weight and underlying disease was recorded. For BP patients, the drugs and the BP Disease Area Index (BPDAI) were recorded as well. Then, all participants underwent brain MRI without contrast. The Fazekas scale, the general cerebral atrophy (GCA) score, and the Medial Temporal lobe Atrophy (MTA) score were used to assess MRI images. Overall, 24 BP patients and 24 controls were evaluated in this study. Both groups were comparable regarding age, gender and education. However, diabetes and hypertension were more frequent in the control group. The mean BPDAI total score was 51.39 ± 68.92 in BP patients and most of them used rituximab (41.7%). None of the participants had MS or Alzheimer MRI patterns. There was no difference between groups in terms of GCA and MTA scores. Furthermore, the frequency of partially empty sella did not differ significantly between BP patients and controls (p = 0.461); nevertheless, grade-3 Fazekas was significantly higher in BP patients compared to controls (25% vs. 0%, p = 0.019). Of note, one BP patient had an epidermoid cyst and another had moderate enlargement of three ventricles. Also, new infarcts were observed in two and old infarcts in four BP patients. Although the majority of abnormal brain MRI findings were more frequent in BP patients compared to controls, only grade-3 Fazekas was significantly higher and acute infarcts were exclusively observed in BP patients.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Brain MRI findings in patients with bullous pemphigoid: A case–control study

Ganji

Mahboubi-Fooladi

Shahidi‐Dadras

et al. 2023

Experimental Dermatology

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“…The relationship between BP and cognitive outcomes is not well understood and may involve multiple factors. Some possible mechanisms include the direct effect of autoantibodies on the central nervous system (CNS), the systemic inflammation induced by BP, the shared genetic susceptibility or environmental triggers between BP and neurological disorders, and the confounding effect of age or other comorbidities [ 15 , 16 ]. Therefore, it is important to confirm the association between BP and cognitive outcomes using rigorous methods and large samples, and to explore the potential mediators and moderators of this relationship.…”

Section: Introductionmentioning

confidence: 99%

The association between bullous pemphigoid and cognitive outcomes in middle-aged and older adults: A systematic review and meta-analysis

Zhou,

Xiong,

Yang

et al. 2023

PLoS ONE

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Background Bullous pemphigoid (BP) is a rare autoimmune skin condition that causes large fluid-filled blisters on the skin, especially in older adults. BP has been linked to various diseases and medications, but its association with cognitive outcomes is unclear. Methods We conducted a systematic review and meta-analysis of studies investigating the association between BP and cognitive outcomes, such as all-cause dementia, Alzheimer’s disease, and vascular dementia in middle-aged and older adults. We searched PubMed, Embase, and Web of Science databases for relevant studies published up to March 2023. We included studies that reported odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between BP and cognitive outcomes. We pooled the ORs, or HRs using random-effects models and performed subgroup and sensitivity analyses to explore potential sources of heterogeneity. Results The study selection process identified 13 studies for inclusion in the analysis, 11 studied arms of which used a case-control design and 7 studied arms of which used a cohort design. The studies were conducted primarily in Europe, with a few from Asia and the United States. The meta-analysis found that BP was associated with higher odds of all-cause dementia in middle-aged and older participants in both cohort studies(HR = 1.41,95% CI: 1.20–1.66, P = 0.000) and case-control (OR = 4.25, 95% CI, 2.73–6.61; P = 0.000). The study found no significant publication bias in the included studies. The meta-regression analyses identified some subgroups associated with significantly reported odds ratios in case-control association analysis, including Europe, BP diagnosed based on clinical, histology, immunofluorescence, and both adjustment status of NO and YES. Conclusions Our meta-analysis suggests that BP is associated with an increased risk of all-cause dementia in middle-aged and older adults. Further studies are needed to elucidate the underlying mechanisms and causal relationship between BP and cognitive outcomes.

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Risk of adverse events in patients with bullous pemphigoid treated with oral corticosteroids in the United States

Silverberg,

Yang,

Alemao

et al. 2024

JEADV Clinical Practice

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BackgroundThe potential association of long‐term oral corticosteroid (OCS) use with adverse events (AEs) in patients with bullous pemphigoid (BP) is not well characterized in a real‐world setting.ObjectiveTo evaluate the effect of OCS use and treatment duration on the incident AEs in patients with BP.MethodsThis retrospective cohort study used medical and pharmacy claims and patient enrollment data from IQVIA PharMetrics® Plus from 2006−2021. Eligible patients had a diagnosis of BP between 1 January 2006 and 30 June 2020 (≥2 claims for BP ≥ 30 days apart). Patients in the OCS cohort also had a claim for OCS use, ≥7.5 mg daily dose of prednisone or equivalent, and no claims for a nonoral systemic corticosteroid (CS) at any time during the study period. A control cohort of patients with BP not using OCS was also selected. Relative risk ratios were estimated between the incidence of AEs in OCS users with different exposure durations (short‐term, <30 days; medium‐term, 30−90 days; long‐term, >90 days) and nonusers by Poisson regression, after adjusting for age, sex, prior drug use, and baseline Charlson Comorbidity Index score within the follow‐up period.ResultsAt the 1‐year follow‐up, long‐term OCS users had a higher incidence of infections, cataract, osteoporosis, heart failure, depression or anxiety, and diabetes compared with OCS nonusers (p < 0.05). Furthermore, compared with nonusers, long‐term users had increased 1‐year risks (risk ratio; 95% confidence interval) for heart failure (2.27; 1.50−3.44), diabetes (2.05; 1.30−3.24), osteoporosis (1.72; 1.23−2.41), and infection (1.50; 1.13−1.99). Long‐term OCS users also had increased 1‐year risks for heart failure (2.00; 1.21−3.28) and osteoporosis (1.70; 1.16−2.50) compared with short‐term OCS users.ConclusionLong‐term OCS use (≥7.5 mg) in patients with BP was associated with an increased risk of AEs. Study findings demonstrate a need for steroid‐sparing options with an improved safety profile.

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Associations among bullous pemphigoid and various neurological diseases: A systematic review and meta‐analysis

Cited by 4 publications

References 42 publications

Brain MRI findings in patients with bullous pemphigoid: A case–control study

Brain MRI findings in patients with bullous pemphigoid: A case–control study

The association between bullous pemphigoid and cognitive outcomes in middle-aged and older adults: A systematic review and meta-analysis

Risk of adverse events in patients with bullous pemphigoid treated with oral corticosteroids in the United States

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