Targets of biologic disease-modifying antirheumatic drugs and risk of multiple myeloma.
Aged
Antirheumatic Agents
/ therapeutic use
Arthritis
/ drug therapy
Biological Products
/ therapeutic use
Case-Control Studies
Databases, Factual
Female
Humans
Interleukin-6
/ antagonists & inhibitors
Male
Middle Aged
Multiple Myeloma
/ chemically induced
Odds Ratio
Retrospective Studies
Tumor Necrosis Factor-alpha
/ antagonists & inhibitors
biologic drugs
epidemiology
immunosuppression
multiple myeloma
rheumatology
risk factors
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
01 09 2020
01 09 2020
Historique:
received:
18
07
2019
revised:
09
01
2020
accepted:
14
01
2020
pubmed:
31
1
2020
medline:
7
4
2021
entrez:
31
1
2020
Statut:
ppublish
Résumé
Several commonly used immune-suppressing biologic drugs target proteins and cytokines involved in myeloma pathogenesis. Our objective was to determine whether targeted biologic disease-modifying antirheumatic drugs (DMARDs) are associated with risk of multiple myeloma (MM). We conducted a nested case-control study within a retrospective cohort of 56,886 commercially insured adults undergoing treatment for rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis between 2009 and 2015 using the Truven Health MarketScan Databases. MM cases (n = 287) were matched to up to 10 controls (n = 2,760) on age, sex and rheumatologic indication using incidence density sampling without replacement. Our exposures of interest were biologic DMARDs targeting tumor necrosis factor-alpha, interleukin 6, cytotoxic t-lymphocyte-associated protein-4 and depletion of B cells. Relative risks were estimated as adjusted odds ratios (OR) and 95% confidence intervals (CI) using conditional logistic regression models. Cases and controls were similar with respect to use of prescription NSAIDs and concurrent conventional-synthetic DMARDs. Cases had slightly fewer etanercept users (4% vs. 7%) and slightly more tocilizumab users (1.4% vs. 0.4%). Compared to patients treated with only conventional-synthetic DMARDs, those receiving concomitant conventional-synthetic plus biologic DMARDs had lower risk of developing MM (OR = 0.48; 95% CI 0.30-0.88; p = 0.02). Risks differed by drug target with an inverse association observed with use of etanercept inhibiting tumor necrosis factor-alpha (OR = 0.55; 95% CI 0.30-1.02; p = 0.06) and a positive association with tocilizumab inhibiting interleukin-6 (OR = 4.33; 95% CI 1.33-14.19; p = 0.02) compared to biologic DMARD-naïve patients. Further investigation is warranted to understand the roles of drugs suppressing tumor necrosis factor-alpha and interleukin-6 in myeloma pathogenesis.
Identifiants
pubmed: 31997371
doi: 10.1002/ijc.32891
pmc: PMC7426969
mid: NIHMS1612208
doi:
Substances chimiques
Antirheumatic Agents
0
Biological Products
0
Interleukin-6
0
Tumor Necrosis Factor-alpha
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1300-1305Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR002002
Pays : United States
Organisme : NHLBI NIH HHS
ID : R21HL140531
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2TR002002
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA223662
Pays : United States
Organisme : NHLBI NIH HHS
ID : R21 HL140531
Pays : United States
Organisme : NCI NIH HHS
ID : R01CA223662
Pays : United States
Informations de copyright
© 2020 UICC.
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