Sex Differences in Autoimmune Multimorbidity Across 11 Autoimmune Disorders in the Real-World Setting in Germany
Author(s)
Karel Kostev, MA, DrPH, MD1, Miriam Claire Guba-Menzel, MSc2, Ira Rodemer, MSc3.
1Senior Scientific Principal, IQVIA Commercial GmbH & Co. OHG, Franfurt am Main, Germany, 2Epidemiology, IQVIA Commercial GmbH & Co. OHG,, Cologne, Germany, 3IQVIA Commercial GmbH & Co. OHG, Munich, Germany.
1Senior Scientific Principal, IQVIA Commercial GmbH & Co. OHG, Franfurt am Main, Germany, 2Epidemiology, IQVIA Commercial GmbH & Co. OHG,, Cologne, Germany, 3IQVIA Commercial GmbH & Co. OHG, Munich, Germany.
OBJECTIVES: While most studies have focused on the incidence, pathogenesis, and severity of individual autoimmune diseases (AID), less attention has been paid to autoimmune multimorbidity—the co-occurrence of multiple AID within the same individual. The present study aims to analyze sex differences in autoimmune multimorbidity across 11 AID in a real-world setting.
METHODS: This retrospective cross-sectional study used data from the Disease Analyzer database (IQVIA) and included 164,596 individuals who had a visit with one of 1037 primary care physicians in 2024 and had at least one predefined AID between 2020 and 2024. The proportions of autoimmune multimorbidity were descriptively compared between female and male patients for each AID
RESULTS: The total number of patients per condition varied widely, with the highest numbers observed in autoimmune thyroiditis (n = 51,765), followed by psoriasis (n = 39,063) and rheumatoid arthritis (n = 33,182). The lowest patient counts were for systemic lupus erythematosus (n = 897) and Sjögren's syndrome (n = 2,728). A notable sex disparity was observed in many conditions. For instance, 30.2% of women but only 25.4% of men with systemic lupus erythematosus, 31.6% of women and 20.7% of men with Sjögren's syndrome, 28.5% of women and 18.6% of men with ankylosing spondylitis, and 20.7% of women versus 12.5% of men with celiac disease had at least one additional AID. Conversely, autoimmune thyroiditis and rheumatoid arthritis showed smaller sex-related differences in autoimmune multimorbidity.
CONCLUSIONS: This study highlights significant sex differences in autoimmune multimorbidity among individuals with predefined AID in a real-world primary care setting. These findings reinforce the notion that women may have a heightened susceptibility to overlapping autoimmune conditions, potentially due to hormonal, genetic, or immunological factors. Overall, the results underscore the clinical importance of monitoring for multiple autoimmune diagnoses, particularly among female patients.
METHODS: This retrospective cross-sectional study used data from the Disease Analyzer database (IQVIA) and included 164,596 individuals who had a visit with one of 1037 primary care physicians in 2024 and had at least one predefined AID between 2020 and 2024. The proportions of autoimmune multimorbidity were descriptively compared between female and male patients for each AID
RESULTS: The total number of patients per condition varied widely, with the highest numbers observed in autoimmune thyroiditis (n = 51,765), followed by psoriasis (n = 39,063) and rheumatoid arthritis (n = 33,182). The lowest patient counts were for systemic lupus erythematosus (n = 897) and Sjögren's syndrome (n = 2,728). A notable sex disparity was observed in many conditions. For instance, 30.2% of women but only 25.4% of men with systemic lupus erythematosus, 31.6% of women and 20.7% of men with Sjögren's syndrome, 28.5% of women and 18.6% of men with ankylosing spondylitis, and 20.7% of women versus 12.5% of men with celiac disease had at least one additional AID. Conversely, autoimmune thyroiditis and rheumatoid arthritis showed smaller sex-related differences in autoimmune multimorbidity.
CONCLUSIONS: This study highlights significant sex differences in autoimmune multimorbidity among individuals with predefined AID in a real-world primary care setting. These findings reinforce the notion that women may have a heightened susceptibility to overlapping autoimmune conditions, potentially due to hormonal, genetic, or immunological factors. Overall, the results underscore the clinical importance of monitoring for multiple autoimmune diagnoses, particularly among female patients.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH213
Topic
Clinical Outcomes, Epidemiology & Public Health
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Neurological Disorders, Rare & Orphan Diseases