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Zhu, L., Huang, Y., Edirisinghe, I., Park, E., & Burton-Freeman, B

To estimate the effects of pauses in these drugs, we calculated the cumulative dose (total number of DDDs) for each drug between the last prescription redeemed prior to or at index date until end of follow-up for each individual

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Additionally, environmental factors such as iodine excess or deficiency, smoking, stress, exposure to chemicals, medications (e.g., amiodarone, interferon-), and some viral/bacterial infections can alter gene expression patterns through epigenetic mechanisms and trigger autoimmune processes