P147 Elevated incidence of autoimmune conditions in people with vitiligo: findings from a large contemporary English cohort

Abstract

Vitiligo is an autoimmune skin disease causing depigmentation and substantial psychosocial burden. With expanding treatment options, robust epidemiological data are needed to contextualize clinical trial adverse events. This study analysed baseline comorbidities and incidence rates of 14 autoimmune outcomes in the largest contemporary English vitiligo cohort to date. This retrospective cohort study used the Clinical Practice Research Datalink (CPRD) Aurum database (≥ 12 years, 2012 to 2023) to identify people with vitiligo and 1 : 5 matched controls. Demographics and comorbidities were described, and incidence rate ratios (IRRs) were estimated using Poisson regression adjusted for age and sex. CPRD primary care data were linked to secondary care, mortality and deprivation records. In total 20 968 individuals with vitiligo were identified and matched to 102 948 unaffected controls. People with vitiligo had a substantial burden of atopic comorbidities and infections at baseline, including allergic rhinitis (16.7%), asthma (15.7%), atopic dermatitis (22.2%) and systemic infections (11.5%). Individuals with vitiligo also showed higher incidence rates for all autoimmune outcomes analysed compared with unaffected controls. Adjusted IRRs (with 95% confidence intervals) confirmed significantly elevated incidence among people with vitiligo for autoimmune thyroiditis (1.98, 1.83–2.14), rheumatoid arthritis (1.68, 1.43–1.96), systemic lupus erythematosus (2.54, 1.49–4.23), Sjögren syndrome (2.85, 1.78–4.49), myasthenia gravis (3.02, 1.11–7.67), systemic sclerosis (9.53, 4.99–19.1), autoimmune blistering diseases (2.09, 1.02–4.03), psoriasis (1.51, 1.29–1.76), pernicious anaemia (2.28, 1.56–3.27) and alopecia areata (3.10, 2.40–3.99). Age stratification at 65 years showed a broadly consistent pattern, although elevated adjusted IRRs for myasthenia gravis and autoimmune blistering diseases were not statistically significant in those aged < 65 years, while associations for autoimmune blistering diseases, psoriasis, pernicious anaemia and alopecia areata were not statistically significant in those aged ≥ 65 years. These findings show that individuals with vitiligo, who have a high burden of atopic comorbidities and infections, may also face a higher risk of diverse autoimmune coexisting conditions compared with matched controls.