Subsets of Idiopathic Inflammatory Myositis Enriched for Contemporaneous Cancer Relative to the General Population

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 l...

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Veröffentlicht in:Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2023-04, Vol.75 (4), p.620-629
Hauptverfasser: Mecoli, Christopher A., Igusa, Tak, Chen, Mengkun, Wang, XingYao, Albayda, Jemima, Paik, Julie J., Tiniakou, Eleni, Adler, Brittany, Richardson, Carrie, Kelly, Will, Danoff, Sonye, Mammen, Andrew L., Platz, Elizabeth A., Rosen, Antony, Christopher‐Stine, Lisa, Casciola‐Rosen, Livia, Shah, Ami A.
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container_issue 4
container_start_page 620
container_title Arthritis & rheumatology (Hoboken, N.J.)
container_volume 75
creator Mecoli, Christopher A.
Igusa, Tak
Chen, Mengkun
Wang, XingYao
Albayda, Jemima
Paik, Julie J.
Tiniakou, Eleni
Adler, Brittany
Richardson, Carrie
Kelly, Will
Danoff, Sonye
Mammen, Andrew L.
Platz, Elizabeth A.
Rosen, Antony
Christopher‐Stine, Lisa
Casciola‐Rosen, Livia
Shah, Ami A.
description 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 
doi_str_mv 10.1002/art.42311
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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 &lt; 0.001; breast SPR 3.84 [95% CI 1.99–6.71], P &lt; 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.</description><identifier>ISSN: 2326-5191</identifier><identifier>ISSN: 2326-5205</identifier><identifier>EISSN: 2326-5205</identifier><identifier>DOI: 10.1002/art.42311</identifier><identifier>PMID: 35878018</identifier><language>eng</language><publisher>Boston, USA: Wiley Periodicals, Inc</publisher><subject>Antibodies ; Autoantibodies ; Breast cancer ; Coenzyme A ; Dermatomyositis ; Dermatomyositis - epidemiology ; Enzymes ; Epidemiology ; Health risks ; Humans ; Hydroxymethylglutaryl-CoA reductase ; Immunoprecipitation ; Inflammation ; Inflammatory diseases ; Malignancy ; Matrix protein ; Melanoma ; Minority &amp; ethnic groups ; Musculoskeletal diseases ; Myopathy ; Myositis ; Neoplasms - epidemiology ; Ovarian cancer ; Population studies ; Proteins ; Reductases ; Retrospective Studies ; Ubiquitin</subject><ispartof>Arthritis &amp; rheumatology (Hoboken, N.J.), 2023-04, Vol.75 (4), p.620-629</ispartof><rights>2022 American College of Rheumatology</rights><rights>2022 American College of Rheumatology.</rights><rights>2023 American College of Rheumatology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4081-ab27bb89c02ca69a06a15fb26a06ef915b72fc1e694cef5abc1e0104e0d6db773</citedby><cites>FETCH-LOGICAL-c4081-ab27bb89c02ca69a06a15fb26a06ef915b72fc1e694cef5abc1e0104e0d6db773</cites><orcidid>0000-0001-8436-1601 ; 0000-0003-4749-870X ; 0000-0003-3732-3252 ; 0000-0002-8030-9504 ; 0000-0002-7150-7306 ; 0000-0002-4172-1539 ; 0000-0002-1429-8392</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fart.42311$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fart.42311$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35878018$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mecoli, Christopher A.</creatorcontrib><creatorcontrib>Igusa, Tak</creatorcontrib><creatorcontrib>Chen, Mengkun</creatorcontrib><creatorcontrib>Wang, XingYao</creatorcontrib><creatorcontrib>Albayda, Jemima</creatorcontrib><creatorcontrib>Paik, Julie J.</creatorcontrib><creatorcontrib>Tiniakou, Eleni</creatorcontrib><creatorcontrib>Adler, Brittany</creatorcontrib><creatorcontrib>Richardson, Carrie</creatorcontrib><creatorcontrib>Kelly, Will</creatorcontrib><creatorcontrib>Danoff, Sonye</creatorcontrib><creatorcontrib>Mammen, Andrew L.</creatorcontrib><creatorcontrib>Platz, Elizabeth A.</creatorcontrib><creatorcontrib>Rosen, Antony</creatorcontrib><creatorcontrib>Christopher‐Stine, Lisa</creatorcontrib><creatorcontrib>Casciola‐Rosen, Livia</creatorcontrib><creatorcontrib>Shah, Ami A.</creatorcontrib><title>Subsets of Idiopathic Inflammatory Myositis Enriched for Contemporaneous Cancer Relative to the General Population</title><title>Arthritis &amp; rheumatology (Hoboken, N.J.)</title><addtitle>Arthritis Rheumatol</addtitle><description>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 &lt; 0.001; breast SPR 3.84 [95% CI 1.99–6.71], P &lt; 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.</description><subject>Antibodies</subject><subject>Autoantibodies</subject><subject>Breast cancer</subject><subject>Coenzyme A</subject><subject>Dermatomyositis</subject><subject>Dermatomyositis - epidemiology</subject><subject>Enzymes</subject><subject>Epidemiology</subject><subject>Health risks</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA reductase</subject><subject>Immunoprecipitation</subject><subject>Inflammation</subject><subject>Inflammatory diseases</subject><subject>Malignancy</subject><subject>Matrix protein</subject><subject>Melanoma</subject><subject>Minority &amp; ethnic groups</subject><subject>Musculoskeletal diseases</subject><subject>Myopathy</subject><subject>Myositis</subject><subject>Neoplasms - epidemiology</subject><subject>Ovarian cancer</subject><subject>Population studies</subject><subject>Proteins</subject><subject>Reductases</subject><subject>Retrospective Studies</subject><subject>Ubiquitin</subject><issn>2326-5191</issn><issn>2326-5205</issn><issn>2326-5205</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUFLHTEUhYO0qFgX_QMl0E1dPE0ymcxkU5CHtQ8sFbXrkMnc9EVmkmmSsbx_39hRaQvN5h64HyfnchB6S8kpJYSd6ZhPOaso3UOHrGJiVTNSv3rWVNIDdJzSPSlPNkSQeh8dVHXbtIS2hyjezl2CnHCweNO7MOm8dQZvvB30OOoc4g5_2YXkskv4wkdnttBjGyJeB59hnELUHsKc8Fp7AxHfwKCzewCcA85bwJfgIeoBX4dpftwE_wa9tnpIcPw0j9C3Txd368-rq6-Xm_X51cpw0tKV7ljTda00hBktpCZC09p2TBQFVtK6a5g1FITkBmytu6IJJRxIL_quaaoj9HHxneZuhN6AzyWImqIbddypoJ36e-PdVn0PD0q2TdVWVTH48GQQw48ZUlajSwaGYblYsfK1FJxyXtD3_6D3YY6-nKdYIxlveSNooU4WysSQUgT7EoYS9VimKmWq32UW9t2f6V_I5-oKcLYAP90Au_87qfObu8XyF3U9q38</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Mecoli, Christopher A.</creator><creator>Igusa, Tak</creator><creator>Chen, Mengkun</creator><creator>Wang, XingYao</creator><creator>Albayda, Jemima</creator><creator>Paik, Julie J.</creator><creator>Tiniakou, Eleni</creator><creator>Adler, Brittany</creator><creator>Richardson, Carrie</creator><creator>Kelly, Will</creator><creator>Danoff, Sonye</creator><creator>Mammen, Andrew L.</creator><creator>Platz, Elizabeth A.</creator><creator>Rosen, Antony</creator><creator>Christopher‐Stine, Lisa</creator><creator>Casciola‐Rosen, Livia</creator><creator>Shah, Ami A.</creator><general>Wiley Periodicals, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8436-1601</orcidid><orcidid>https://orcid.org/0000-0003-4749-870X</orcidid><orcidid>https://orcid.org/0000-0003-3732-3252</orcidid><orcidid>https://orcid.org/0000-0002-8030-9504</orcidid><orcidid>https://orcid.org/0000-0002-7150-7306</orcidid><orcidid>https://orcid.org/0000-0002-4172-1539</orcidid><orcidid>https://orcid.org/0000-0002-1429-8392</orcidid></search><sort><creationdate>202304</creationdate><title>Subsets of Idiopathic Inflammatory Myositis Enriched for Contemporaneous Cancer Relative to the General Population</title><author>Mecoli, Christopher A. ; Igusa, Tak ; Chen, Mengkun ; Wang, XingYao ; Albayda, Jemima ; Paik, Julie J. ; Tiniakou, Eleni ; Adler, Brittany ; Richardson, Carrie ; Kelly, Will ; Danoff, Sonye ; Mammen, Andrew L. ; Platz, Elizabeth A. ; Rosen, Antony ; Christopher‐Stine, Lisa ; Casciola‐Rosen, Livia ; Shah, Ami A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4081-ab27bb89c02ca69a06a15fb26a06ef915b72fc1e694cef5abc1e0104e0d6db773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antibodies</topic><topic>Autoantibodies</topic><topic>Breast cancer</topic><topic>Coenzyme A</topic><topic>Dermatomyositis</topic><topic>Dermatomyositis - epidemiology</topic><topic>Enzymes</topic><topic>Epidemiology</topic><topic>Health risks</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA reductase</topic><topic>Immunoprecipitation</topic><topic>Inflammation</topic><topic>Inflammatory diseases</topic><topic>Malignancy</topic><topic>Matrix protein</topic><topic>Melanoma</topic><topic>Minority &amp; ethnic groups</topic><topic>Musculoskeletal diseases</topic><topic>Myopathy</topic><topic>Myositis</topic><topic>Neoplasms - epidemiology</topic><topic>Ovarian cancer</topic><topic>Population studies</topic><topic>Proteins</topic><topic>Reductases</topic><topic>Retrospective Studies</topic><topic>Ubiquitin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mecoli, Christopher A.</creatorcontrib><creatorcontrib>Igusa, Tak</creatorcontrib><creatorcontrib>Chen, Mengkun</creatorcontrib><creatorcontrib>Wang, XingYao</creatorcontrib><creatorcontrib>Albayda, Jemima</creatorcontrib><creatorcontrib>Paik, Julie J.</creatorcontrib><creatorcontrib>Tiniakou, Eleni</creatorcontrib><creatorcontrib>Adler, Brittany</creatorcontrib><creatorcontrib>Richardson, Carrie</creatorcontrib><creatorcontrib>Kelly, Will</creatorcontrib><creatorcontrib>Danoff, Sonye</creatorcontrib><creatorcontrib>Mammen, Andrew L.</creatorcontrib><creatorcontrib>Platz, Elizabeth A.</creatorcontrib><creatorcontrib>Rosen, Antony</creatorcontrib><creatorcontrib>Christopher‐Stine, Lisa</creatorcontrib><creatorcontrib>Casciola‐Rosen, Livia</creatorcontrib><creatorcontrib>Shah, Ami A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium &amp; 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rheumatology (Hoboken, N.J.)</jtitle><addtitle>Arthritis Rheumatol</addtitle><date>2023-04</date><risdate>2023</risdate><volume>75</volume><issue>4</issue><spage>620</spage><epage>629</epage><pages>620-629</pages><issn>2326-5191</issn><issn>2326-5205</issn><eissn>2326-5205</eissn><abstract>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 &lt; 0.001; breast SPR 3.84 [95% CI 1.99–6.71], P &lt; 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.</abstract><cop>Boston, USA</cop><pub>Wiley Periodicals, Inc</pub><pmid>35878018</pmid><doi>10.1002/art.42311</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8436-1601</orcidid><orcidid>https://orcid.org/0000-0003-4749-870X</orcidid><orcidid>https://orcid.org/0000-0003-3732-3252</orcidid><orcidid>https://orcid.org/0000-0002-8030-9504</orcidid><orcidid>https://orcid.org/0000-0002-7150-7306</orcidid><orcidid>https://orcid.org/0000-0002-4172-1539</orcidid><orcidid>https://orcid.org/0000-0002-1429-8392</orcidid></addata></record>
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subjects Antibodies
Autoantibodies
Breast cancer
Coenzyme A
Dermatomyositis
Dermatomyositis - epidemiology
Enzymes
Epidemiology
Health risks
Humans
Hydroxymethylglutaryl-CoA reductase
Immunoprecipitation
Inflammation
Inflammatory diseases
Malignancy
Matrix protein
Melanoma
Minority & ethnic groups
Musculoskeletal diseases
Myopathy
Myositis
Neoplasms - epidemiology
Ovarian cancer
Population studies
Proteins
Reductases
Retrospective Studies
Ubiquitin
title Subsets of Idiopathic Inflammatory Myositis Enriched for Contemporaneous Cancer Relative to the General Population
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