...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Arthritis & Rheumatism >Juvenile idiopathic arthritis and risk of cancer: A nationwide cohort study
【24h】

Juvenile idiopathic arthritis and risk of cancer: A nationwide cohort study

机译：青少年特发性关节炎与癌症风险：一项全国性队列研究

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

ObjectiveReports of therapy-related adverse events suggest an elevated rate of malignancy in patients with juvenile idiopathic arthritis (JIA) treated with biologic therapies. However, the scarcity of data on the underlying risk of malignancy in JIA hampers interpretation of these signals. Therefore, the aim of this study was to determine the risk of cancer in patients with JIA as compared with that in the general population.MethodsThrough linkage with a national database, the Swedish Patient Register (comprising inpatient discharges in 1969–2007 and specialist outpatient visits in 2001–2007 in Sweden), a national JIA cohort (n = 9,027) was identified, and each JIA case was matched with 5 general population comparators. Using data from the Swedish Cancer, Census, Death, and Biologics Registers, the occurrence of cancer, vital status, and start of a biologic therapy were identified. The relative risk (RR) of first occurrence of a primary cancer in patients who had not been treated with biologics (biologics-naive patients with JIA) was estimated using Poisson regression, stratified a priori by year of earliest identification of JIA (before 1987 versus 1987 and thereafter). In sensitivity analyses, the data were followed up to 1999, when biologics first became available.ResultsIn this biologics-naive JIA cohort, 60 malignancies were observed during 131,144 person-years of followup, compared with 266 cancers observed during 661,758 person-years in the general population comparator (0.46 cases/1,000 person-years versus 0.40 cases/1,000 person-years; RR 1.1, 95% confidence interval [95% CI] 0.9–1.5). Patients with JIA identified before 1987 were not at increased risk of cancer, whereas JIA identified in 1987 and thereafter was significantly associated with incident lymphoproliferative malignancies (RR 4.2, 95% CI 1.7–10.7) and cancers overall (RR 2.3, 95% CI 1.2–4.4). Sensitivity analyses did not reveal any ready explanation for this heterogeneity.ConclusionAlthough absolute risks were low, an elevated risk of malignancy was observed among biologics-naive patients in whom the diagnosis of JIA was made in the past 20 years, which may have implications for the interpretation of cancer signals in patients with JIA treated with newer therapies.
机译：目的与治疗相关的不良事件的报告表明，用生物疗法治疗的青少年特发性关节炎（JIA）患者的恶性肿瘤发病率升高。但是，JIA中有关潜在的恶性肿瘤风险的数据缺乏，阻碍了对这些信号的解释。因此，本研究的目的是确定与一般人群相比，JIA患者的癌症风险。方法通过与国家数据库，瑞典患者登记表（包含1969-2007年的住院病人出院和专业门诊就诊）的链接（2001-2007年在瑞典），确定了全国JIA队列（n = 9,027），每个JIA病例都与5名一般人口比较者进行了匹配。使用来自瑞典癌症，人口普查，死亡和生物制剂登记簿的数据，确定了癌症的发生，生命状态和生物疗法的开始。未进行过生物制剂治疗的患者（未接受过生物制剂治疗的JIA患者）首次发生原发癌的相对风险（RR）使用Poisson回归进行估算，并按最早识别JIA的年份进行了先验分层（1987年之前与1987年及之后）。在敏感性分析中，数据一直追踪到1999年首次获得生物制剂时。结果在这个未使用生物制剂的JIA队列中，在131,144人-年的随访期间观察到60例恶性肿瘤，而在661,758人-年期间观察到266例癌症。一般人群比较者（0.46例/ 1,000人年与0.40例/ 1,000人年； RR 1.1，95％置信区间[95％CI] 0.9-1.5）。 1987年之前确定的JIA患者患癌症的风险并未增加，而1987年及之后的JIA患者与淋巴增生性恶性肿瘤（RR 4.2，95％CI 1.7-10.7）和整体癌症（RR 2.3，95％CI 1.2）显着相关–4.4）。敏感性分析尚未发现这种异质性的任何现成解释。结论尽管绝对风险较低，但在过去20年中诊断为JIA的未使用过生物制剂的患者中，恶性肿瘤的风险较高。新型疗法治疗的JIA患者的癌症信号解释。

著录项

  • 来源
    《Arthritis & Rheumatism》 |2010年第12期|p.3776-3782|共7页
  • 作者

    J. F. Simard; M. Neovius; S. Hagelberg; J. Askling;

  • 作者单位

    Karolinska Institutet, Stockholm, Sweden;

    Karolinska Institutet, Stockholm, Sweden;

    Astrid Lindgren Children's Hospital at Karolinska University Hospital, Stockholm, Sweden;

    |Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden|;

  • 收录信息
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号