Lymphoma risk in systemic lupus: effects of disease activity versus treatment

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Fältnamn	Indikatorer	Metadata
000		05030naa a2200781 4500
001		oai:lup.lub.lu.se:97446c64-d19f-43f8-813a-4ddd7dabbbbb
003		SwePub
008		160401s2014 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://lup.lub.lu.se/record/42722402 URI
024	7	a https://doi.org/10.1136/annrheumdis-2012-2020992 DOI
040		a (SwePub)lu
041		a engb eng
042		9 SwePub
072	7	a art2 swepub-publicationtype
072	7	a ref2 swepub-contenttype
100	1	a Bernatsky, Sasha4 aut
245	1 0	a Lymphoma risk in systemic lupus: effects of disease activity versus treatment
264		c 2013-01-08
264	1	b BMJ,c 2014
520		a Objective To examine disease activity versus treatment as lymphoma risk factors in systemic lupus erythematosus (SLE). Methods We performed case-cohort analyses within a multisite SLE cohort. Cancers were ascertained by regional registry linkages. Adjusted HRs for lymphoma were generated in regression models, for time-dependent exposures to immunomodulators (cyclophosphamide, azathioprine, methotrexate, mycophenolate, antimalarial drugs, glucocorticoids) demographics, calendar year, Sjogren's syndrome, SLE duration and disease activity. We used adjusted mean SLE Disease Activity Index scores (SLEDAI-2K) over time, and drugs were treated both categorically (ever/never) and as estimated cumulative doses. Results We studied 75 patients with lymphoma (72 non-Hodgkin, three Hodgkin) and 4961 cancer-free controls. Most lymphomas were of B-cell origin. As is seen in the general population, lymphoma risk in SLE was higher in male than female patients and increased with age. Lymphomas occurred a mean of 12.4years (median 10.9) after SLE diagnosis. Unadjusted and adjusted analyses failed to show a clear association of disease activity with lymphoma risk. There was a suggestion of greater exposure to cyclophosphamide and to higher cumulative steroids in lymphoma cases than the cancer-free controls. Conclusions In this large SLE sample, there was a suggestion of higher lymphoma risk with exposure to cyclophosphamide and high cumulative steroids. Disease activity itself was not clearly associated with lymphoma risk. Further work will focus on genetic profiles that might interact with medication exposure to influence lymphoma risk in SLE.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reumatologi och inflammation0 (SwePub)302102 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Rheumatology and Autoimmunity0 (SwePub)302102 hsv//eng
653		a Systemic Lupus Erythematosus
653		a Epidemiology
653		a Treatment
653		a Disease Activity
700	1	a Ramsey-Goldman, Rosalind4 aut
700	1	a Joseph, Lawrence4 aut
700	1	a Boivin, Jean-Francois4 aut
700	1	a Costenbader, Karen H.4 aut
700	1	a Urowitz, Murray B.4 aut
700	1	a Gladman, Dafna D.4 aut
700	1	a Fortin, Paul R.4 aut
700	1	a Nived, Olau Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine4 aut0 (Swepub:lu)reum-oni
700	1	a Petri, Michelle A.4 aut
700	1	a Jacobsen, Soren4 aut
700	1	a Manzi, Susan4 aut
700	1	a Ginzler, Ellen M.4 aut
700	1	a Isenberg, David4 aut
700	1	a Rahman, Anisur4 aut
700	1	a Gordon, Caroline4 aut
700	1	a Ruiz-Irastorza, Guillermo4 aut
700	1	a Yelin, Edward4 aut
700	1	a Bae, Sang-Cheol4 aut
700	1	a Wallace, Daniel J.4 aut
700	1	a Peschken, Christine A.4 aut
700	1	a Dooley, Mary Anne4 aut
700	1	a Edworthy, Steven M.4 aut
700	1	a Aranow, Cynthia4 aut
700	1	a Kamen, Diane L.4 aut
700	1	a Romero-Diaz, Juanita4 aut
700	1	a Askanase, Anca4 aut
700	1	a Witte, Torsten4 aut
700	1	a Barr, Susan G.4 aut
700	1	a Criswell, Lindsey A.4 aut
700	1	a Sturfelt, Gunnaru Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine4 aut0 (Swepub:lu)reum-gst
700	1	a Blanco, Irene4 aut
700	1	a Feldman, Candace H.4 aut
700	1	a Dreyer, Lene4 aut
700	1	a Patel, Neha M.4 aut
700	1	a St Pierre, Yvan4 aut
700	1	a Clarke, Ann E.4 aut
710	2	a Reumatologi och molekylär skelettbiologib Sektion III4 org
773	0	t Annals of the Rheumatic Diseasesd : BMJg 73:1, s. 138-142q 73:1<138-142x 1468-2060x 0003-4967
856	4	u http://dx.doi.org/10.1136/annrheumdis-2012-202099y FULLTEXT
856	4	u https://europepmc.org/articles/pmc3855611?pdf=render
856	4 8	u https://lup.lub.lu.se/record/4272240
856	4 8	u https://doi.org/10.1136/annrheumdis-2012-202099

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