RESUMEN
AIM: Patients with systemic sclerosis (SSc) are at increased risk of cancer, a growing cause of non-SSc-related death among these patients. We analyzed the increased cancer risk among Spanish patients with SSc using standardized incidence ratios (SIRs) and identified independent cancer risk factors in this population. MATERIAL AND METHODS: Spanish Scleroderma Registry data were analyzed to determine the demographic characteristics of patients with SSc, and logistic regression was used to identify cancer risk factors. SIRs with 95% confidence intervals (CIs) relative to the general Spanish population were calculated. RESULTS: Of 1930 patients with SSc, 206 had cancer, most commonly breast, lung, hematological, and colorectal cancers. Patients with SSc had increased risks of overall cancer (SIR 1.48, 95% CI 1.36-1.60; P < 0.001), and of lung (SIR 2.22, 95% CI 1.77-2.73; P < 0.001), breast (SIR 1.31, 95% CI 1.10-1.54; P = 0.003), and hematological (SIR 2.03, 95% CI 1.52-2.62; P < 0.001) cancers. Cancer was associated with older age at SSc onset (odds ratio [OR] 1.22, 95% CI 1.01-1.03; P < 0.001), the presence of primary biliary cholangitis (OR 2.35, 95% CI 1.18-4.68; P = 0.015) and forced vital capacity <70% (OR 1.8, 95% CI 1.24-2.70; P = 0.002). The presence of anticentromere antibodies lowered the risk of cancer (OR 0.66, 95% CI 0.45-0.97; P = 0.036). CONCLUSIONS: Spanish patients with SSc had an increased cancer risk compared with the general population. Some characteristics, including specific autoantibodies, may be related to this increased risk.
Asunto(s)
Neoplasias , Esclerodermia Localizada , Esclerodermia Sistémica , Autoanticuerpos , Humanos , Incidencia , Neoplasias/complicaciones , Neoplasias/epidemiología , Sistema de Registros , Factores de Riesgo , Esclerodermia Localizada/complicaciones , Esclerodermia Sistémica/complicaciones , Esclerodermia Sistémica/epidemiologíaRESUMEN
OBJECTIVES: To assess the incidence of venous thromboembolic events in dermatomyositis and polymyositis patients, and associated factors. METHODS: We retrospectively studied a cohort of 123 myositis patients (87 dermatomyositis, 36 polymyositis) from a single centre and identified cases with deep vein thrombosis and/or pulmonary embolism. Type of myositis, association with cancer, presence of thrombophilia, disease activity, and intravenous immunoglobulin therapy were analysed. Incidence rates were calculated on the basis of time to first venous thrombotic event. Patients with less than 12 months' follow-up were excluded. RESULTS: Six new first thromboembolic events occurred in 6 of 96 patients studied (6.3%), all with dermatomyositis. Median time to development of venous thromboembolism was 4.3 months (IQR, 0.8-8.8) after the dermatomyositis diagnosis. Venous thromboembolism was significantly associated with intravenous immunoglobulin therapy (p<0.05) and older age (p<0.05), but not with cancer. All events (100%) occurred during active myositis. The incidence density of venous thromboembolism among patients with dermatomyositis according to the first year of follow-up was 9.3 per 1000 person-years (95% CI, 3.4 to 20.3). CONCLUSIONS: A trend toward venous thromboembolism was detected in patients with dermatomyositis.
Asunto(s)
Dermatomiositis/epidemiología , Tromboembolia Venosa/epidemiología , Adulto , Anciano , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Modelos de Riesgos Proporcionales , Embolia Pulmonar/epidemiología , Estudios RetrospectivosRESUMEN
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