Prevalence and comorbidities associated with hidradenitis suppurativa in Korea: a nationwide population‐based study

Lee, Ji Hae; Kwon, Hyuck Sun; Jung, Han Mi; Kim, G.M.; Bae, Jung Min

doi:10.1111/jdv.15071

Cited by 111 publications

(203 citation statements)

References 46 publications

(105 reference statements)

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“…Additional references were identified from reference lists. After application of inclusion and exclusion criteria, 12 studies were included in the systematic review and meta‐analysis (Table ), of which 5 studies had adjusted effect sizes available for extraction. The included study characteristics and demographics of these studies are summarized in Table .…”

Section: Resultsmentioning

confidence: 99%

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

2019

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Summary Background Hidradenitis suppurativa (HS) is a debilitating and distressing chronic inflammatory skin disease. There is also evolving evidence supporting the association between HS and cardiovascular risk factors, including smoking, obesity, hyperlipidaemia and metabolic syndrome. Notably, these are clinical features and risk factors that are closely associated with type 2 diabetes mellitus (DM). Aims We performed a pooled adjusted meta‐analysis of comparative studies to investigate the relationship between HS and DM. Methods A systematic review and meta‐analysis was performed according to recommended Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. OR was used as the summary effect size. Results From pooled analysis of unadjusted data from 12 studies, we found a significantly higher proportion of DM in HS cases compared with non‐HS healthy controls (16.1% vs. 15.7%; OR = 2.17; 95% CI 1.85–2.55; P < 0.001). Adjusted effect sizes from five studies were also pooled. A significantly higher proportion of DM was found for HS compared with healthy controls, although the effect size was attenuated compared with unadjusted analyses (OR 1.69; 95% CI 1.50–1.91; P < 0.001). Conclusions To our knowledge, our systematic review and meta‐analysis is the first to pool adjusted effect sizes. We found that HS was associated with a 1.69‐fold increased odds of diabetes; however, the absolute risk difference was small (16.1% vs. 15.7%) and is probably not clinically relevant. Treating clinicians should be aware of this association, but there may not be an urgent need to perform screening for impaired glucose tolerance or diabetes.

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Section: Resultsmentioning

confidence: 99%

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

2019

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“…33 Atypical cases of HS tend to lack the associations that typical HS have with gender, glucose intolerance, obesity, and metabolic syndrome. Atypical cases of HS may be more predominant in the Malaysian 17 and Asian populations, 34 which explains the lack of association between HS and metabolic syndrome in the study by Loo and colleagues. HS also has other underlying genetic predisposing factors.…”

Section: Discussionmentioning

confidence: 96%

Hidradenitis suppurativa and metabolic syndrome – systematic review and adjusted meta‐analysis

2019

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Background Hidradenitis suppurativa (HS) is a debilitating and distressing chronic systemic inflammatory skin disease. There have been several prior observational studies which reported a possibility link between HS and metabolic syndrome, however the current evidence is not definitive. It is unclear in HS whether this possible relationship is independent or driven by underlying risk factors and comorbidities. Objective To determine whether HS is independently associated with metabolic syndrome via adjusted meta‐analysis of case‐control studies. Methods A systematic review and meta‐analysis was performed according to PRISMA guidelines. Electronic searches were performed using six electronic databases (Ovid Medline, PubMed, CCTR, CDSR, ACP Journal Club, and DARE) from their inception until September 2018. Data were extracted and analyzed according to predefined clinical endpoints. Results We identified six case‐control studies included for meta‐analysis. Based on unadjusted analysis, we found a significant association between adult cases of HS and metabolic syndrome (OR 1.95, 95% CI 1.31–2.89, P = 0.001). Adjusted meta‐analysis, after adjustment for age, sex, other cardiovascular risk factors, and comorbidities, found a significant association (OR 2.19, 95% CI 1.70–2.81, I2 = 32%, P < 0.00001). Limitations Studies reviewed were observational by design which are susceptible to bias, and there was lack of randomization. The quality of the current systematic review is also limited by the quality of available evidence which was predominantly observational in nature. Conclusions This pooled analysis of existing case‐control studies supports an association between HS and metabolic syndrome. Clinicians treating patients with HS should be aware of this potential association.

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“…More recent epidemiological studies have shown that the majority of HS patients are white; however, these findings are dependent on how and where data are collected and may reflect the racial demographics of the areas in which the studies are conducted . Relatively few studies have investigated HS epidemiology in Asian populations . Using the Korean National Health Insurance database, the prevalence of HS in South Korea is estimated to be 0.06% .…”

Section: Discussionmentioning

confidence: 99%

“…The disease usually presents after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, most commonly the axillary, inguinal and anogenital regions (Dessau definition), all of which negatively affect patients' quality of life (QOL). 1,2 Prevalence of HS varies between Eastern and Western countries, [3][4][5][6] and the clinical manifestations of HS are heterogeneous. 7 Clinical studies from Western countries found that HS is 2-5-times more common in women than in men, with skin lesions more commonly occurring in inguinal and axillary folds and anogenital regions.…”

Section: Introductionmentioning

confidence: 99%

Twenty‐four‐week interim analysis from a phase 3 open‐label trial of adalimumab in Japanese patients with moderate to severe hidradenitis suppurativa

Morita

Takahashi

Ozawa

et al. 2019

The Journal of Dermatology

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Hidradenitis suppurativa (HS) is a chronic skin disease characterized by recurrent painful inflamed nodules/abscesses and draining fistulas that negatively impact quality of life. Adalimumab, a monoclonal antibody against tumor necrosis factor‐α, has been approved in the EU, USA and Japan for the treatment of moderate to severe HS. This is an interim analysis of an ongoing phase 3, multicenter, open‐label, single‐arm study of the safety and efficacy of adalimumab weekly dosing in Japanese patients with moderate to severe HS. Fifteen patients received adalimumab 160 mg at week 0, 80 mg at week 2 and 40 mg every week thereafter starting at week 4. The fulfillment of Hidradenitis Suppurativa Clinical Response was assessed under adalimumab treatment; clinical response was assessed by skin pain, total abscess and inflammatory nodule count and modified Sartorius score; and quality of life and safety were assessed. At week 12, 86.7% of patients achieved clinical response, with improvements at week 12 across the primary and secondary end points generally sustained through week 24. Adalimumab weekly dosing was generally safe and well tolerated with no new safety findings through week 24. These results suggest that adalimumab is effective and well tolerated in Japanese patients with moderate to severe HS.

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Prevalence and comorbidities associated with hidradenitis suppurativa in Korea: a nationwide population‐based study

Abstract: The overall prevalence of HS in Korea was lower than that in Western populations, and male patients predominated.

Cited by 111 publications

References 46 publications

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

Hidradenitis suppurativa and metabolic syndrome – systematic review and adjusted meta‐analysis

Twenty‐four‐week interim analysis from a phase 3 open‐label trial of adalimumab in Japanese patients with moderate to severe hidradenitis suppurativa

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