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Hormonal Dependence and Cancer in Systemic Lupus Erythematosus

Authors :
Cobo‐Ibáñez, Tatiana
Urruticoechea‐Arana, Ana
Rúa‐Figueroa, Iñigo
Martín‐Martínez, María A.
Ovalles‐Bonilla, Juan Gabriel
Galindo, María
Calvo‐Alén, Jaime
Olivé, Alejandro
Fernández‐Nebro, Antonio
Menor‐Almagro, Raúl
Tomero, Eva
Horcada, Loreto
Uriarte‐Itzazelaia, Esther
Martínez‐Taboada, Víctor M.
Andreu, José Luis
Boteanu, Alina
Narváez, Javier
Bohorquez, Cristina
Montilla, Carlos
Santos, Gregorio
Hernández‐Cruz, Blanca
Vela, Paloma
Salgado, Eva
Freire, Mercedes
Hernández‐Beriain, José Ángel
Díez‐Álvarez, Elvira
Expósito, Lorena
Fernández‐Berrizbeitia, Olaia
Velloso‐Feijoo, María Luisa
Ibáñez‐Barceló, Mónica
Lozano‐Rivas, Nuria
Bonilla, Gema
Moreno, Mireia
Raya, Enrique
Quevedo‐Vila, Víctor Eliseo
Vázquez‐Rodríguez, Tomas Ramón
Ibáñez‐Ruan, Jesús
Muñoz‐Fernández, Santiago
Sánchez‐Alonso, Fernando
Pego‐Reigosa, José María
Source :
Arthritis Care and Research; February 2020, Vol. 72 Issue: 2 p216-224, 9p
Publication Year :
2020

Abstract

To estimate the incidence and analyze any cancer‐associated factors in patients with systemic lupus erythematosus (SLE), differentiating between hormone‐sensitive (HS) and non‐HScancers. This was a retrospective multicenter study of a patient cohort from the Systemic Lupus Erythematosus Registry of the Spanish Society of Rheumatology. Included were the first cancer post‐SLEdiagnosis, clinical and sociodemographic information, cumulative damage, severity, comorbidities, treatments, and refractoriness. Cancers were classified as HS(prostate, breast, endometrium, and ovarian) and non‐HS(the remainder). The standardized incidence ratio (SIR) was calculated and logistic regression models were built. A total of 3,539 patients (90.4% women) were included, 154 of whom had cancer (91% female), and 44 had HScancer (100% female). The cancer SIR was 1.37 (95% confidence interval [95% CI] 1.15–1.59), with higher values in women age <65 years (SIR 2.38 [95% CI1.84–2.91]). The SIR in women with HSversus non‐HScancer was 1.02 (95% CI0.13–1.91) and 1.93 (95% CI0.98–2.89). In HSversus non‐HScancers, SLEdiagnostic age (odds ratio [OR] 1.04 [P= 0.002] versus 1.04 [P= 0.019]), and period of disease evolution (OR1.01 [P< 0.001] versus 1.00 [P= 0.029]) were associated with cancer. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (OR1.27 [P= 0.022]) and angiotensin‐converting enzyme (ACE) inhibitor prescriptions (OR2.87 [P= 0.048]) were associated with non‐HScancers. Cancer incidence in patients with SLEwas higher than in the Spanish population, particularly among young women. This increase might be due to non‐HScancers, which would be associated with SLEinvolving greater cumulative damage where more ACEinhibitors are prescribed.

Details

Language :
English
ISSN :
2151464X and 15290123
Volume :
72
Issue :
2
Database :
Supplemental Index
Journal :
Arthritis Care and Research
Publication Type :
Periodical
Accession number :
ejs52264785
Full Text :
https://doi.org/10.1002/acr.24068