Antimalarials may influence the risk of malignancy in systemic lupus erythematosus
Identifieur interne : 001B84 ( Main/Exploration ); précédent : 001B83; suivant : 001B85Antimalarials may influence the risk of malignancy in systemic lupus erythematosus
Auteurs : G. Ruiz-Irastorza [Espagne] ; A. Ugarte [Espagne] ; M V Egurbide [Espagne] ; M. Garmendia [Espagne] ; J I Pijoan [Espagne] ; A. Martinez-Berriotxoa [Espagne] ; C. Aguirre [Espagne]Source :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2007-06.
English descriptors
- KwdEn :
- Teeft :
- American college, Antimalarial, Arthritis rheum, Azathioprine, Basque country, Carcinoma, Chloroquine, Cohort, Conventional treatment, Cyclophosphamide, Damage index, Egurbide, Erythematosus, Garmendia, Glioblastoma, Glioblastoma multiforme, Hazard ratio, Independent association, Independent variables, Lower frequency, Lupus, Malignancy, Median, Methotrexate, Neoplasm, Potential influence, Proportional hazards model, Recent randomised, Rheum, Rheumatology, Rheumatology criteria, Severe damage, Slicc, Survival curves, Systemic, Systemic lupus, Systemic lupus erythematosus.
Abstract
Background: Recent studies suggest that antimalarials have antineoplastic properties. Objective: To investigate whether antimalarials decrease the risk of cancer in systemic lupus erythematosus (SLE). Methods: An observational prospective cohort study was carried out. 235 patients were included in the study at the time of diagnosis (American College of Rheumatology criteria). The end point was the diagnosis of cancer. Kaplan–Meier cancer-free survival curves for patients treated and not treated with antimalarials were compared. A Cox proportional hazards model was fitted, with cancer as the dependent variable. Age at diagnosis, gender, treatment with azathioprine, cyclophosphamide and methotrexate, smoking, Systemic Lupus International Collaborating Clinics (SLICC) Damage Index 6 months after diagnosis, year of diagnosis and treatment with antimalarials were entered as independent variables. Results: 209 (89%) patients were women. 233 (99%) patients were white. Mean (SD) age at diagnosis was 37 (16) years. Median (range) follow-up was 10 (1–31) years. 156 (66%) patients had ever received antimalarials. 2/156 (1.3%) ever-treated patients compared with 11/79 (13%) never-treated patients had cancer (p<0.001). Cumulative cancer-free survival in treated and not treated patients was 0.98 and 0.73, respectively (p<0.001). Adjusted hazard ratio for cancer among malaria drug users compared with non-users was 0.15 (95% CI 0.02 to 0.99). Conclusions: This study launches the hypothesis of a protective action of antimalarials against cancer in patients with SLE. This effect should be confirmed in larger multicentre studies.
Url:
DOI: 10.1136/ard.2006.067777
Affiliations:
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Garmendia</name><affiliation wicri:level="1"><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia</wicri:regionArea><wicri:noRegion>Bizkaia</wicri:noRegion></affiliation></author><author><name sortKey="Pijoan, J I" sort="Pijoan, J I" uniqKey="Pijoan J" first="J I" last="Pijoan">J I Pijoan</name><affiliation wicri:level="1"><country xml:lang="fr">Espagne</country><wicri:regionArea>Clinical Epidemiology Unit, Hospital de Cruces, University of the Basque Country, Bizkaia</wicri:regionArea><wicri:noRegion>Bizkaia</wicri:noRegion></affiliation></author><author><name sortKey="Martinez Berriotxoa, A" sort="Martinez Berriotxoa, A" uniqKey="Martinez Berriotxoa A" first="A" last="Martinez-Berriotxoa">A. Martinez-Berriotxoa</name><affiliation wicri:level="1"><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia</wicri:regionArea><wicri:noRegion>Bizkaia</wicri:noRegion></affiliation></author><author><name sortKey="Aguirre, C" sort="Aguirre, C" uniqKey="Aguirre C" first="C" last="Aguirre">C. Aguirre</name><affiliation wicri:level="1"><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia</wicri:regionArea><wicri:noRegion>Bizkaia</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of the Rheumatic Diseases</title><title level="j" type="abbrev">Ann Rheum Dis</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><date type="published" when="2007-06">2007-06</date><biblScope unit="volume">66</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="815">815</biblScope></imprint><idno type="ISSN">0003-4967</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0003-4967</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>SDI, Systemic Lupus International Collaborating Clinics (SLICC) Damage Index</term><term>SLE, systemic lupus erythematosus</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>American college</term><term>Antimalarial</term><term>Arthritis rheum</term><term>Azathioprine</term><term>Basque country</term><term>Carcinoma</term><term>Chloroquine</term><term>Cohort</term><term>Conventional treatment</term><term>Cyclophosphamide</term><term>Damage index</term><term>Egurbide</term><term>Erythematosus</term><term>Garmendia</term><term>Glioblastoma</term><term>Glioblastoma multiforme</term><term>Hazard ratio</term><term>Independent association</term><term>Independent variables</term><term>Lower frequency</term><term>Lupus</term><term>Malignancy</term><term>Median</term><term>Methotrexate</term><term>Neoplasm</term><term>Potential influence</term><term>Proportional hazards model</term><term>Recent randomised</term><term>Rheum</term><term>Rheumatology</term><term>Rheumatology criteria</term><term>Severe damage</term><term>Slicc</term><term>Survival curves</term><term>Systemic</term><term>Systemic lupus</term><term>Systemic lupus erythematosus</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Recent studies suggest that antimalarials have antineoplastic properties. Objective: To investigate whether antimalarials decrease the risk of cancer in systemic lupus erythematosus (SLE). Methods: An observational prospective cohort study was carried out. 235 patients were included in the study at the time of diagnosis (American College of Rheumatology criteria). The end point was the diagnosis of cancer. Kaplan–Meier cancer-free survival curves for patients treated and not treated with antimalarials were compared. A Cox proportional hazards model was fitted, with cancer as the dependent variable. Age at diagnosis, gender, treatment with azathioprine, cyclophosphamide and methotrexate, smoking, Systemic Lupus International Collaborating Clinics (SLICC) Damage Index 6 months after diagnosis, year of diagnosis and treatment with antimalarials were entered as independent variables. Results: 209 (89%) patients were women. 233 (99%) patients were white. Mean (SD) age at diagnosis was 37 (16) years. Median (range) follow-up was 10 (1–31) years. 156 (66%) patients had ever received antimalarials. 2/156 (1.3%) ever-treated patients compared with 11/79 (13%) never-treated patients had cancer (p<0.001). Cumulative cancer-free survival in treated and not treated patients was 0.98 and 0.73, respectively (p<0.001). Adjusted hazard ratio for cancer among malaria drug users compared with non-users was 0.15 (95% CI 0.02 to 0.99). Conclusions: This study launches the hypothesis of a protective action of antimalarials against cancer in patients with SLE. This effect should be confirmed in larger multicentre studies.</div></front></TEI><affiliations><list><country><li>Espagne</li></country></list><tree><country name="Espagne"><noRegion><name sortKey="Ruiz Irastorza, G" sort="Ruiz Irastorza, G" uniqKey="Ruiz Irastorza G" first="G" last="Ruiz-Irastorza">G. Ruiz-Irastorza</name></noRegion><name sortKey="Aguirre, C" sort="Aguirre, C" uniqKey="Aguirre C" first="C" last="Aguirre">C. Aguirre</name><name sortKey="Egurbide, M V" sort="Egurbide, M V" uniqKey="Egurbide M" first="M V" last="Egurbide">M V Egurbide</name><name sortKey="Garmendia, M" sort="Garmendia, M" uniqKey="Garmendia M" first="M" last="Garmendia">M. Garmendia</name><name sortKey="Martinez Berriotxoa, A" sort="Martinez Berriotxoa, A" uniqKey="Martinez Berriotxoa A" first="A" last="Martinez-Berriotxoa">A. Martinez-Berriotxoa</name><name sortKey="Pijoan, J I" sort="Pijoan, J I" uniqKey="Pijoan J" first="J I" last="Pijoan">J I Pijoan</name><name sortKey="Ugarte, A" sort="Ugarte, A" uniqKey="Ugarte A" first="A" last="Ugarte">A. Ugarte</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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