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Rheumatoid arthritis, treatment with corticosteroids and risk of malignant lymphomas: results from a case-control study
- Source :
- Annals of the rheumatic diseases. 69(4)
- Publication Year :
- 2009
-
Abstract
- Benefits and risks of corticosteroid treatment in rheumatoid arthritis (RA) are debated. Patients with RA are at increased risk of malignant lymphomas. In a large case-control study of risk factors for lymphoma in RA, it was recently reported that steroid treatment was associated with decreased lymphoma risk.To further assess the nature of the association between steroid treatment in RA and the risk of lymphoma.In a cohort of 74 651 patients with RA, 378 patients with lymphoma and 378 matched RA controls were identified, and information on inflammatory activity and different aspects of steroid treatment (duration, therapeutic strategy and mode of administration) abstracted from their medical records. Lymphomas were reclassified (WHO classification) and examined for Epstein-Barr virus. Relative risks were assessed as adjusted odds ratios (ORs) through conditional logistic regression.A total duration of oral steroid treatment of2 years was not associated with lymphoma risk (OR=0.87; 95% CI 0.51 to 1.5), whereas total treatment2 years was associated with a lower lymphoma risk (OR=0.43; 95% CI 0.26 to 0.72). RA duration at the initiation of oral steroids did not affect lymphoma risk. Intra-articular steroids were associated with a reduced lymphoma risk, but only when used as swift flare treatment (OR=0.22; 95% CI 0.13 to 0.37). Analyses by lymphoma subtype showed a reduced risk of diffuse large B-cell lymphoma (crude OR=0.59; 95% CI 0.37 to 0.94).In this RA population, use of steroids was associated with reduced lymphoma risk. Whether this association is a generic effect of steroids or specific to the studied population remains unknown.
- Subjects :
- Oncology
Adult
Male
medicine.medical_specialty
Adolescent
Lymphoma
Immunology
Population
Arthritis
Administration, Oral
General Biochemistry, Genetics and Molecular Biology
Injections, Intra-Articular
Arthritis, Rheumatoid
Young Adult
Rheumatology
hemic and lymphatic diseases
Internal medicine
medicine
Immunology and Allergy
Humans
Risk factor
education
Glucocorticoids
Aged
Aged, 80 and over
Sweden
education.field_of_study
business.industry
Case-control study
Odds ratio
Middle Aged
medicine.disease
Rheumatoid arthritis
Relative risk
Antirheumatic Agents
Female
business
Epidemiologic Methods
Subjects
Details
- ISSN :
- 14682060
- Volume :
- 69
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Annals of the rheumatic diseases
- Accession number :
- edsair.doi.dedup.....7c44f36370a2f7d98cd9fc065b188ad0