Abstract
Objective: The association between autoimmune diseases (ADs) and interstitial cystitis/bladder pain syndrome (IC/BPS) has long been investigated. However, the lack of comprehensive descriptions of patients in the literature has made comparison and evaluation impossible. We aim to investigate the risk of systemic ADs in patients with IC/BPS in Taiwan using a population-based administrative database.Methods: This study evaluated 1,095 patients newly diagnosed with IC/BPS between 2000 and 2013, using data from Taiwan's National Health Insurance Research Database. These patients were randomly matched by demographic characteristics with a comparison cohort of individuals without IC/BPS at a ratio of 1:20. Cox proportional hazards regression analysis was used to analyze the risk of ADs, adjusting for age, sex, urbanization, length of hospital stay, and comorbidities adjustment. Sensitivity analysis by propensity score was used to adjust for confounding factors.Results: The adjusted Hazard Ratio (aHR) of ADs for IC/BPS patients was 1.409 (95% CI 1.152–1.725). The subgroup analysis indicated that female or 45–60 years of age had a greater risk of ADs. Furthermore, the subgroup analysis of primary outcomes indicated that IC/BPS had greater incidence with Hashimoto's thyroiditis (aHR = 2.767, 95% CI 1.039–7.368), ankylosing spondylitis (aHR = 2.429, 95% CI 1.264–4.67), rheumatoid arthritis (aHR = 1.516, 95% CI 1.001–2.296), and Sjogren's syndrome (aHR = 1.962, 95% CI 1.37–2.809).Conclusion: IC/BPS was associated with the development of ADs in our study population, especially Hashimoto's thyroiditis, ankylosing spondylitis, rheumatoid arthritis, and Sjogren's syndrome. Clinicians are recommended to be alert to the increased likelihood of developing ADs, particularly for middle-aged women.
Highlights
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic inflammatory disease characterized by recurrent pain, discomfort, or tenderness in the urinary bladder and pelvic region and can be accompanied by various urinary symptoms, such as urinary frequency, persistent urge to void, and nocturia
The precise identities of relevant autoantibodies have yet to be determined, some speculate that the increased prevalence of Autoimmune diseases (ADs) among patients with IC/BPS may involve the presence of shared underlying autoimmune disturbances
A total of 1,095 patients with IC/BPS and 21,900 1:20matched non-IC/BPS controls were selected for this study
Summary
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic inflammatory disease characterized by recurrent pain, discomfort, or tenderness in the urinary bladder and pelvic region and can be accompanied by various urinary symptoms, such as urinary frequency, persistent urge to void, and nocturia. The overall prevalence of IC/BPS is roughly 300 cases per 105 patients, with a five times higher incidence in women than men [1]. Autoimmune diseases (ADs), considered to occur infrequently, substantially influence mortality and morbidity of patients. Some studies have reported on autoantibodies in patients with IC/BPS [3,4,5]. Kujala et al proposed a possible link between ADs and IC/BPS in patients with certain immunological factors or genetic predispositions [6]. Numerous studies on autoantibodies against nuclear or bladder epithelium antigens in patients with IC/BPS appear in the literature [7, 8]. The precise identities of relevant autoantibodies have yet to be determined, some speculate that the increased prevalence of ADs among patients with IC/BPS may involve the presence of shared underlying autoimmune disturbances
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