Incidence of malignancy in patients treated for antineutrophil cytoplasm antibody-associated vasculitis: follow-up data from European Vasculitis Study Group clinical trials
| Autor: | Heijl, C., Harper, L., Flossmann, O., Stucker, I., Scott, D.G.I., Watts, R.A., Hoglund, P., Westman, K., Mahr, A., European Vasculitis Study Grp EUVA |
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| Přispěvatelé: | Faculteit Medische Wetenschappen/UMCG |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Skin Neoplasms Cyclophosphamide Immunology Population BLADDER-CANCER Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis THERAPY General Biochemistry Genetics and Molecular Biology WEGENERS-GRANULOMATOSIS Rheumatology Neoplasms Internal medicine Azathioprine CYCLOPHOSPHAMIDE medicine Humans Multicenter Studies as Topic Immunology and Allergy COHORT POLYANGIITIS education METAANALYSIS Aged Randomized Controlled Trials as Topic RISK education.field_of_study Bladder cancer business.industry Cancer Middle Aged medicine.disease RANDOMIZED-TRIAL METHOTREXATE Europe Female Skin cancer Epidemiologic Methods Microscopic polyangiitis Vasculitis Granulomatosis with polyangiitis business Immunosuppressive Agents medicine.drug |
| Zdroj: | Annals of the Rheumatic Diseases, 70(8), 1415-1421. BMJ PUBLISHING GROUP Annals of the Rheumatic Diseases, 70(8), 1415-1421 |
| ISSN: | 0003-4967 1415-1421 |
| DOI: | 10.1136/ard.2010.145250 |
| Popis: | Objectives Because standard immunosuppressive treatment for antineutrophil cytoplasm antibody-associated vasculitis (AAV) (granulomatosis with polyangiitis (Wegener's) (GPA) and microscopic polyangiitis (MPA)) has been associated with a significant risk of developing cancer, the cancer incidence of treated AAV patients was assessed.Methods This analysis concerned 535 patients with newly diagnosed AAV from 15 countries who had been enrolled between 1995 and 2002 in four European clinical trials. Over the period 2004-7, study participants' follow-up events were updated, including cancers diagnosed. Age, sex and area-standardised incidence ratios (SIR) and their 95% CI were calculated by linkage to five national cancer databases.Results During the 2650 person-years' observation period, 50 cancers were diagnosed in 46 patients. SIR (95% CI) were 1.58 (1.17 to 2.08) for cancers at all sites, 1.30 (0.90 to 1.80) for cancers at all sites excluding non-melanoma skin cancer (NMSC), 2.41 (0.66 to 6.17) for bladder cancer, 3.23 (0.39 to 11.65) for leukaemia, 1.11 (0.03 to 6.19) for lymphoma and 2.78 (1.56 to 4.59) for NMSC. Subgroup SIR for cancers at all sites were 1.92 (1.31 to 2.71) for GPA and 1.20 (0.71 to 1.89) for MPA.Conclusions Cancer rates for AAV patients treated with conventional immunosuppressive therapy exceeded those expected for the general population. This cancer excess was largely driven by an increased incidence of NMSC. The smaller cancer risk magnitude in this cohort, compared with previous studies, might reflect less extensive use of cyclophosphamide in current treatment protocols. Longer follow-up data are warranted to appraise the risk of developing cancers later during the course of AAV. |
| Databáze: | OpenAIRE |
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