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Ann Rheum Dis doi:10.1136/ard.2006.067777

Antimalarials may influence the risk of malignancy in systemic lupus erythematosus

  1. G Ruiz-Irastorza (r.irastorza{at}euskalnet.net)
  1. Hospital de Cruces-University of the Basque Country, Spain
    1. A Ugarte
    1. Hospital de Cruces-University of the Basque Country, Spain
      1. M-V Egurbide
      1. Hospital de Cruces-University of the Basque Country, Spain
        1. M Garmendia
        1. Hospital de Cruces-University of the Basque Country, Spain
          1. J-I Pijoan
          1. Hospital de Cruces-University of the Basque Country, Spain
            1. A Martinez-Berriotxoa
            1. Hospital de Cruces-University of the Basque Country, Spain
              1. C Aguirre
              1. Hospital de Cruces-University of the Basque Country, Spain
                • Published Online First 4 January 2007

                Abstract

                Background: Recent studies suggest that antimalarials have antineoplastic properties.

                Objective: To investigate whether antimalarials decrease the risk of cancer in SLE.

                Methods: Observational prospective cohort study. 235 patients included in the study at the time of diagnosis (ACR criteria). The end point was the diagnosis of cancer. Kaplan-Meier free-of-cancer survival curves for patients treated and non-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, SDI 6 months after diagnosis, year of diagnosis and treatment with antimalarials were entered as independent variables.

                Results: 209 patients (89%) were women. 233 patients (99%) were white. Mean (SD) age at diagnosis was 37(16) years. Median follow-up was 10 years (range 1- 31). 156 patients (66%) ever received antimalarials. 2/156 ever (1.3%) vs. 11/79 never treated patients (13%) had cancer (p<0.001). Cumulative free-of-cancer survival in treated and untreated patients was 0.98 vs. 0.73, respectively (p=0.0003). Adjusted HR for cancer among antimalarials users vs. non-users was 0.15 (95%CI 0.02- 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 multicentric studies.

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