TY - JOUR
T1 - Subsets of Idiopathic Inflammatory Myositis Enriched for Contemporaneous Cancer Relative to the General Population
AU - Mecoli, Christopher A.
AU - Igusa, Tak
AU - Chen, Mengkun
AU - Wang, Xing Yao
AU - Albayda, Jemima
AU - Paik, Julie J.
AU - Tiniakou, Eleni
AU - Adler, Brittany
AU - Richardson, Carrie
AU - Kelly, Will
AU - Danoff, Sonye
AU - Mammen, Andrew L.
AU - Platz, Elizabeth A.
AU - Rosen, Antony
AU - Christopher-Stine, Lisa
AU - Casciola-Rosen, Livia
AU - Shah, Ami A.
N1 - Funding Information:
Supported by the Jerome L. Greene Foundation, the Donald B. and Dorothy L. Stabler Foundation, the Huayi and Siuling Zhang Discovery Fund, and the NIH (grant P30-CA-006973). Dr. Mecoli's work (grant 1K23-AR-075898), Dr. Paik's work (grant K23-AR-0739), Dr. Richardson's work (grant 5T32-AR-048522-15), Dr. Shah's work (grant K24-AR-080217), and Drs. Igusa's, Rosen's, Casciola-Rosen's, and Shah's work (grants P30-AR-070254 and R01-AR-073208) were supported by the NIH. Dr. Mammen's work was supported by the NIH Intramural Research Program of the National Institute of Musculoskeletal and Skin Diseases.
Publisher Copyright:
© 2022 American College of Rheumatology.
PY - 2023/4
Y1 - 2023/4
N2 - Objective: This study investigates cancer risk in idiopathic inflammatory myopathy (IIM) relative to the general population. Methods: We conducted a single-center, retrospective cohort study of IIM patients and malignancy. Myositis-specific and -associated autoantibodies were determined by Euroimmun line blot, enzyme-linked immunosorbent assay, and immunoprecipitation. We calculated standardized prevalence ratios (SPRs) and adjusted for calendar year, age, sex, race, and ethnicity by comparing observed cancers in IIM patients versus expected cancers in the general population using the Surveillance, Epidemiology, and End Results registry. Results: Of 1,172 IIM patients, 203 (17%) patients with a cancer history were studied. Over a median follow-up of 5.2 years, the observed number of IIM patients diagnosed with cancer was increased 1.43-fold (SPR 1.43 [95% confidence interval (95% CI) 1.15–1.77]; P = 0.002). Within 3 years of IIM symptom onset, an increased SPR was observed for anti–transcription intermediary factor 1γ (anti-TIF1γ)–positive patients for ovarian and breast cancer (ovarian SPR 18.39 [95% CI 5.01–47.08], P < 0.001; breast SPR 3.84 [95% CI 1.99–6.71], P < 0.001). As expected, anti-TIF1γ positivity was associated with a significantly elevated SPR; however, only 55% (36 of 66) of all cancers within 3 years of dermatomyositis onset were observed in anti-TIF1γ–positive patients. Other myositis-specific autoantibodies, including anti–Mi-2, anti–small ubiquitin-like modifier activating enzyme (SAE), and anti-nuclear matrix protein 2 (NXP-2), accounted for 26% (17 of 66) of cancers diagnosed within 3 years of dermatomyositis onset. No cancer association, positive or negative, was observed for patients with antisynthetase, anti–melanoma differentiation–associated protein 5 (anti–MDA-5), or anti–hydroxymethylglutaryl-coenzyme A reductase (anti-HMGCR) antibodies. Conclusion: In a tertiary referral center population, anti-TIF1γ was most strongly associated with breast and ovarian cancer. Patients with antisynthetase, anti–MDA-5, or anti-HMGCR antibodies had the same cancer risk as the general population. (Figure presented.).
AB - Objective: This study investigates cancer risk in idiopathic inflammatory myopathy (IIM) relative to the general population. Methods: We conducted a single-center, retrospective cohort study of IIM patients and malignancy. Myositis-specific and -associated autoantibodies were determined by Euroimmun line blot, enzyme-linked immunosorbent assay, and immunoprecipitation. We calculated standardized prevalence ratios (SPRs) and adjusted for calendar year, age, sex, race, and ethnicity by comparing observed cancers in IIM patients versus expected cancers in the general population using the Surveillance, Epidemiology, and End Results registry. Results: Of 1,172 IIM patients, 203 (17%) patients with a cancer history were studied. Over a median follow-up of 5.2 years, the observed number of IIM patients diagnosed with cancer was increased 1.43-fold (SPR 1.43 [95% confidence interval (95% CI) 1.15–1.77]; P = 0.002). Within 3 years of IIM symptom onset, an increased SPR was observed for anti–transcription intermediary factor 1γ (anti-TIF1γ)–positive patients for ovarian and breast cancer (ovarian SPR 18.39 [95% CI 5.01–47.08], P < 0.001; breast SPR 3.84 [95% CI 1.99–6.71], P < 0.001). As expected, anti-TIF1γ positivity was associated with a significantly elevated SPR; however, only 55% (36 of 66) of all cancers within 3 years of dermatomyositis onset were observed in anti-TIF1γ–positive patients. Other myositis-specific autoantibodies, including anti–Mi-2, anti–small ubiquitin-like modifier activating enzyme (SAE), and anti-nuclear matrix protein 2 (NXP-2), accounted for 26% (17 of 66) of cancers diagnosed within 3 years of dermatomyositis onset. No cancer association, positive or negative, was observed for patients with antisynthetase, anti–melanoma differentiation–associated protein 5 (anti–MDA-5), or anti–hydroxymethylglutaryl-coenzyme A reductase (anti-HMGCR) antibodies. Conclusion: In a tertiary referral center population, anti-TIF1γ was most strongly associated with breast and ovarian cancer. Patients with antisynthetase, anti–MDA-5, or anti-HMGCR antibodies had the same cancer risk as the general population. (Figure presented.).
UR - http://www.scopus.com/inward/record.url?scp=85146293030&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85146293030&partnerID=8YFLogxK
U2 - 10.1002/art.42311
DO - 10.1002/art.42311
M3 - Article
C2 - 35878018
AN - SCOPUS:85146293030
SN - 2326-5191
VL - 75
SP - 620
EP - 629
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
IS - 4
ER -