BACKGROUND: Recent studies suggest that antimalarials have antineoplastic properties. OBJECTIVE: To investigate whether antimalarials decrease the risk of cancer in systemic lupus erythematosus (SLE). METHODS: An observational prospective cohort study was carried out. 235 patients were included in the study at the time of diagnosis (American College of Rheumatology criteria). The end point was the diagnosis of cancer. Kaplan-Meier cancer-free survival curves for patients treated and not treated with antimalarials were compared. A Cox proportional hazards model was fitted, with cancer as the dependent variable. Age at diagnosis, gender, treatment with azathioprine, cyclophosphamide and methotrexate, smoking, Systemic Lupus International Collaborating Clinics (SLICC) Damage Index 6 months after diagnosis, year of diagnosis and treatment with antimalarials were entered as independent variables. RESULTS: 209 (89%) patients were women. 233 (99%) patients were white. Mean (SD) age at diagnosis was 37 (16) years. Median (range) follow-up was 10 (1-31) years. 156 (66%) patients had ever received antimalarials. 2/156 (1.3%) ever-treated patients compared with 11/79 (13%) never-treated patients had cancer (p<0.001). Cumulative cancer-free survival in treated and not treated patients was 0.98 and 0.73, respectively (p<0.001). Adjusted hazard ratio for cancer among malaria drug users compared with non-users was 0.15 (95% CI 0.02 to 0.99). CONCLUSIONS: This study launches the hypothesis of a protective action of antimalarials against cancer in patients with SLE. This effect should be confirmed in larger multicentre studies.
BACKGROUND: Recent studies suggest that antimalarials have antineoplastic properties. OBJECTIVE: To investigate whether antimalarials decrease the risk of cancer in systemic lupus erythematosus (SLE). METHODS: An observational prospective cohort study was carried out. 235 patients were included in the study at the time of diagnosis (American College of Rheumatology criteria). The end point was the diagnosis of cancer. Kaplan-Meier cancer-free survival curves for patients treated and not treated with antimalarials were compared. A Cox proportional hazards model was fitted, with cancer as the dependent variable. Age at diagnosis, gender, treatment with azathioprine, cyclophosphamide and methotrexate, smoking, Systemic Lupus International Collaborating Clinics (SLICC) Damage Index 6 months after diagnosis, year of diagnosis and treatment with antimalarials were entered as independent variables. RESULTS: 209 (89%) patients were women. 233 (99%) patients were white. Mean (SD) age at diagnosis was 37 (16) years. Median (range) follow-up was 10 (1-31) years. 156 (66%) patients had ever received antimalarials. 2/156 (1.3%) ever-treated patients compared with 11/79 (13%) never-treated patients had cancer (p<0.001). Cumulative cancer-free survival in treated and not treated patients was 0.98 and 0.73, respectively (p<0.001). Adjusted hazard ratio for cancer among malaria drug users compared with non-users was 0.15 (95% CI 0.02 to 0.99). CONCLUSIONS: This study launches the hypothesis of a protective action of antimalarials against cancer in patients with SLE. This effect should be confirmed in larger multicentre studies.
Authors: S Bernatsky; J F Boivin; L Joseph; R Rajan; A Zoma; S Manzi; E Ginzler; M Urowitz; D Gladman; P R Fortin; M Petri; S Edworthy; S Barr; C Gordon; S C Bae; J Sibley; D Isenberg; A Rahman; C Aranow; M A Dooley; K Steinsson; O Nived; G Sturfelt; G Alarcón; J L Senécal; M Zummer; J Hanly; S Ensworth; J Pope; H El-Gabalawy; T McCarthy; Y St Pierre; R Ramsey-Goldman; A Clarke Journal: Arthritis Rheum Date: 2005-05
Authors: D D Gladman; C H Goldsmith; M B Urowitz; P Bacon; P Fortin; E Ginzler; C Gordon; J G Hanly; D A Isenberg; M Petri; O Nived; M Snaith; G Sturfelt Journal: J Rheumatol Date: 2000-02 Impact factor: 4.666
Authors: G Ruiz-Irastorza; M V Egurbide; J I Pijoan; M Garmendia; I Villar; A Martinez-Berriotxoa; J G Erdozain; C Aguirre Journal: Lupus Date: 2006 Impact factor: 2.911
Authors: Sasha Bernatsky; Rosalind Ramsey-Goldman; Jeremy Labrecque; Lawrence Joseph; Jean-Francois Boivin; Michelle Petri; Asad Zoma; Susan Manzi; Murray B Urowitz; Dafna Gladman; Paul R Fortin; Ellen Ginzler; Edward Yelin; Sang-Cheol Bae; Daniel J Wallace; Steven Edworthy; Soren Jacobsen; Caroline Gordon; Mary Anne Dooley; Christine A Peschken; John G Hanly; Graciela S Alarcón; Ola Nived; Guillermo Ruiz-Irastorza; David Isenberg; Anisur Rahman; Torsten Witte; Cynthia Aranow; Diane L Kamen; Kristjan Steinsson; Anca Askanase; Susan Barr; Lindsey A Criswell; Gunnar Sturfelt; Neha M Patel; Jean-Luc Senécal; Michel Zummer; Janet E Pope; Stephanie Ensworth; Hani El-Gabalawy; Timothy McCarthy; Lene Dreyer; John Sibley; Yvan St Pierre; Ann E Clarke Journal: J Autoimmun Date: 2013-02-12 Impact factor: 7.094
Authors: May Y Choi; Kelsey Flood; Sasha Bernatsky; Rosalind Ramsey-Goldman; Ann E Clarke Journal: Best Pract Res Clin Rheumatol Date: 2017-11-10 Impact factor: 4.098
Authors: S Bernatsky; R Ramsey-Goldman; M Petri; M B Urowitz; D D Gladman; P R Fortin; E Ginzler; J Romero-Diaz; C Peschken; S Jacobsen; J G Hanly; C Gordon; O Nived; E H Yelin; D Isenberg; A Rahman; S-C Bae; L Joseph; T Witte; G Ruiz-Irastorza; C Aranow; D Kamen; G Sturfeldt; W D Foulkes; J E Hansen; Y St Pierre; P Chrétien Raymer; B Tessier-Cloutier; A E Clarke Journal: Lupus Date: 2016-09-30 Impact factor: 2.911