PMID- 21616914
OWN - NLM
STAT- MEDLINE
DCOM- 20111118
LR  - 20220311
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 70
IP  - 8
DP  - 2011 Aug
TI  - Incidence of malignancy in patients treated for antineutrophil cytoplasm 
      antibody-associated vasculitis: follow-up data from European Vasculitis Study 
      Group clinical trials.
PG  - 1415-21
LID - 10.1136/ard.2010.145250 [doi]
AB  - OBJECTIVES: Because standard immunosuppressive treatment for antineutrophil 
      cytoplasm antibody-associated vasculitis (AAV) (granulomatosis with polyangiitis 
      (Wegener's) (GPA) and microscopic polyangiitis (MPA)) has been associated with a 
      significant risk of developing cancer, the cancer incidence of treated AAV 
      patients was assessed. METHODS: This analysis concerned 535 patients with newly 
      diagnosed AAV from 15 countries who had been enrolled between 1995 and 2002 in 
      four European clinical trials. Over the period 2004-7, study participants' 
      follow-up events were updated, including cancers diagnosed. Age, sex and 
      area-standardised incidence ratios (SIR) and their 95% CI were calculated by 
      linkage to five national cancer databases. RESULTS: During the 2650 person-years' 
      observation period, 50 cancers were diagnosed in 46 patients. SIR (95% CI) were 
      1.58 (1.17 to 2.08) for cancers at all sites, 1.30 (0.90 to 1.80) for cancers at 
      all sites excluding non-melanoma skin cancer (NMSC), 2.41 (0.66 to 6.17) for 
      bladder cancer, 3.23 (0.39 to 11.65) for leukaemia, 1.11 (0.03 to 6.19) for 
      lymphoma and 2.78 (1.56 to 4.59) for NMSC. Subgroup SIR for cancers at all sites 
      were 1.92 (1.31 to 2.71) for GPA and 1.20 (0.71 to 1.89) for MPA. CONCLUSIONS: 
      Cancer rates for AAV patients treated with conventional immunosuppressive therapy 
      exceeded those expected for the general population. This cancer excess was 
      largely driven by an increased incidence of NMSC. The smaller cancer risk 
      magnitude in this cohort, compared with previous studies, might reflect less 
      extensive use of cyclophosphamide in current treatment protocols. Longer 
      follow-up data are warranted to appraise the risk of developing cancers later 
      during the course of AAV.
FAU - Heijl, C
AU  - Heijl C
AD  - Department of Nephrology, Skane University Hospital Lund, Lund University, Lund, 
      Sweden.
FAU - Harper, L
AU  - Harper L
FAU - Flossmann, O
AU  - Flossmann O
FAU - Stucker, I
AU  - Stucker I
FAU - Scott, D G I
AU  - Scott DG
FAU - Watts, R A
AU  - Watts RA
FAU - Hoglund, P
AU  - Hoglund P
FAU - Westman, K
AU  - Westman K
FAU - Mahr, A
AU  - Mahr A
CN  - European Vasculitis Study Group (EUVAS)
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20110525
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - 0 (Immunosuppressive Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - MRK240IY2L (Azathioprine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*drug 
      therapy/epidemiology
MH  - Azathioprine/adverse effects
MH  - Cyclophosphamide/adverse effects
MH  - Epidemiologic Methods
MH  - Europe/epidemiology
MH  - Female
MH  - Humans
MH  - Immunosuppressive Agents/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Multicenter Studies as Topic
MH  - Neoplasms/*epidemiology
MH  - Randomized Controlled Trials as Topic
MH  - Skin Neoplasms/epidemiology
FIR - Bajema, I
IR  - Bajema I
FIR - Berden, A
IR  - Berden A
FIR - le Cessie, S
IR  - le Cessie S
FIR - de Groot, K
IR  - de Groot K
FIR - Ekstrand, A
IR  - Ekstrand A
FIR - Hagen, E C
IR  - Hagen EC
FIR - Herlyn, K
IR  - Herlyn K
FIR - Jayne, D
IR  - Jayne D
FIR - Luqmani, R
IR  - Luqmani R
FIR - Mukhtyar, C
IR  - Mukhtyar C
FIR - Neumann, I
IR  - Neumann I
FIR - Rasmussen, N
IR  - Rasmussen N
FIR - Salmela, A
IR  - Salmela A
FIR - Selga, Daina
IR  - Selga D
FIR - Stegeman, C
IR  - Stegeman C
FIR - Walsh, M
IR  - Walsh M
EDAT- 2011/05/28 06:00
MHDA- 2011/12/13 00:00
CRDT- 2011/05/28 06:00
PHST- 2011/05/28 06:00 [entrez]
PHST- 2011/05/28 06:00 [pubmed]
PHST- 2011/12/13 00:00 [medline]
AID - ard.2010.145250 [pii]
AID - 10.1136/ard.2010.145250 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2011 Aug;70(8):1415-21. doi: 10.1136/ard.2010.145250. Epub 2011 
      May 25.