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To investigate the bidirectional epidemiological association between vitiligo and RA. A population-based study was conducted using Clalit Health Services (CHS) database (2002\u20132019) using both a cohort study and a case-control study design. Adjusted hazard ratio (HR) and odds ratio (OR) were calculated by multivariate Cox and logistic regressions, respectively. Overall, 20,851 vitiligo patients and 102,475 controls were included. The incidence of new-onset RA was 4.1 (95% CI 3.0\u20135.4) and 2.9 (95% CI 2.4\u20133.3) cases per 10,000 person-years among patients with vitiligo and controls, respectively. Patients with vitiligo had a significantly increased risk of developing new-onset RA (adjusted HR, 1.44; 95% confidence interval [CI], 1.02\u20132.02, <jats:italic>P<\/jats:italic>\u2009=\u20090.036). The likelihood of having vitiligo was significantly elevated after a preexisting diagnosis of RA (adjusted OR, 1.67; 95% CI, 1.38\u20132.03; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Relative to the remaining patients with vitiligo, those with vitiligo and comorbid RA demonstrated an elevated risk of all-cause mortality (adjusted HR, 1.61; 95% CI, 1.03\u20132.51; <jats:italic>P<\/jats:italic>\u2009=\u20090.037). Our study confirms the bidirectional association between vitiligo and RA. Physicians treating patients with vitiligo should be aware of the association in clinical practice.<\/jats:p>","DOI":"10.1007\/s00403-024-02965-7","type":"journal-article","created":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T10:01:23Z","timestamp":1717840883000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A bidirectional autoimmune cluster between vitiligo and rheumatoid arthritis: a large-scale population-based study"],"prefix":"10.1007","volume":"316","author":[{"given":"Naama Tova","family":"Cohen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yochai","family":"Schonmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalaf","family":"Kridin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,8]]},"reference":[{"key":"2965_CR1","doi-asserted-by":"publisher","unstructured":"Joge RR, Kathane PU, Joshi SH (2022) Vitiligo: a narrative review article. 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