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Malignancies in Patients with Anti-RNA Polymerase III Antibodies and Systemic Sclerosis: Analysis of the EULAR Scleroderma Trials and Research Cohort and Possible Recommendations for Screening.
Lazzaroni, Maria-Grazia; Cavazzana, Ilaria; Colombo, Enrico; Dobrota, Rucsandra; Hernandez, Jasmin; Hesselstrand, Roger; Varju, Cecilia; Nagy, Gabriella; Smith, Vanessa; Caramaschi, Paola; Riccieri, Valeria; Hachulla, Eric; Balbir-Gurman, Alexandra; Chatelus, Emmanuel; Romanowska-Próchnicka, Katarzyna; Araújo, Ana Carolina; Distler, Oliver; Allanore, Yannick; Airò, Paolo.
Afiliación
  • Lazzaroni MG; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
  • Cavazzana I; M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia;
  • Colombo E; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
  • Dobrota R; M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia;
  • Hernandez J; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
  • Hesselstrand R; M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia;
  • Varju C; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
  • Nagy G; M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia;
  • Smith V; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
  • Caramaschi P; M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia;
  • Riccieri V; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
  • Hachulla E; M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia;
  • Balbir-Gurman A; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
  • Chatelus E; M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia;
  • Romanowska-Próchnicka K; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
  • Araújo AC; M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia;
  • Distler O; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
  • Allanore Y; M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia;
  • Airò P; From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, Un
J Rheumatol ; 44(5): 639-647, 2017 05.
Article en En | MEDLINE | ID: mdl-28089973
ABSTRACT

OBJECTIVE:

To analyze the characteristics of anti-RNA polymerase III antibodies (anti-RNAP3)- positive patients with systemic sclerosis (SSc) in the European League Against Rheumatism Scleroderma Trials and Research group (EUSTAR) registry with a focus on the risk of cancer and the characteristics of malignancies, and the aim to provide guidelines about potential cancer screening in these patients.

METHODS:

(1) Analysis of the EUSTAR database 4986 patients with information on their anti-RNAP3 status were included. (2) Case-control study additional retrospective data, including malignancy history, were queried in 13 participating EUSTAR centers; 158 anti-RNAP3+ cases were compared with 199 local anti-RNAP3- controls, matched for sex, cutaneous subset, disease duration, and age at SSc onset. (3) A Delphi exercise was performed by 82 experts to reach consensus for cancer screening in anti-RNAP3+ patients.

RESULTS:

In the EUSTAR registry, anti-RNAP3 were associated in multivariable analysis with renal crisis and diffuse cutaneous involvement. In the case-control study, anti-RNAP3 were associated with gastric antral vascular ectasia, rapid progression of skin involvement, and malignancies concomitant to SSc onset (OR 7.38, 95% CI 1.61-33.8). When compared with other anti-RNAP3+ patients, those with concomitant malignancies had older age (p < 0.001) and more frequent diffuse cutaneous involvement (p = 0.008). The Delphi exercise highlighted the need for malignancy screening at the time of diagnosis for anti-RNAP3+ patients and tight followup in the following years.

CONCLUSION:

Anti-RNAP3+ patients with SSc have a high risk of concomitant malignancy. These results have implications for clinical practice and suggest regular screening for cancer in anti-RNAP3+ patients.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Esclerodermia Sistémica / Autoanticuerpos / ARN Polimerasa III / Neoplasias Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Idioma: En Revista: J Rheumatol Año: 2017 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Esclerodermia Sistémica / Autoanticuerpos / ARN Polimerasa III / Neoplasias Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Idioma: En Revista: J Rheumatol Año: 2017 Tipo del documento: Article