Some Dermatomyositis Patients May Benefit from Cancer Screenings

In a recent study, researchers analyzed the relationship between anti-transcriptional intermediary factor 1 antibody (anti-TIF1-Ab)-positive/-negative dermatomyositis (DM) patients and the odds of developing cancer. They found that, over all, anti-TIF1-Ab-negative DM patients have a higher risk of cancer, and diagnosis is most common three years before or after DM onset.

Data from the UK Myositis Network register were collected on anti-TIF1-Ab-positive/-negative patients with verified DM diagnoses, who were followed until they developed cancer. Of a total 263 DM cases, 55 (21%) were anti-TIF1-Ab positive. After a decade of follow-up, the anti-TIF1-Ab positive patients were more than three times as likely to develop cancer as the anti-TIF1-Ab negative cohort: 38% vs 15% [hazard ratio 3.4 (95% CI 2.2, 5.4)]. All anti-TIF1-Ab positive patients who developed cancer were diagnosed three years prior to and 2.5 years after DM onset—no cancer diagnoses were made after this time in anti-TIF1-Ab positive patients, but anti-TIF1-Ab negative patients did receive cancer diagnoses during this time.

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“This finding is not likely to be due to a disparity in follow-up time between anti-TIF1-Ab-positive and -negative cases, as the median follow-up times were similar for both groups: 10 years and 12 years, respectively,” the researchers wrote. “Further, this finding is unlikely to be due to differences in cancer detection methods, as both cohorts’ cancer diagnoses were identified through [the UK Health and Social Care Information Centre] data, ensuring capture of all incident cancers during the follow-up period.”

Female anti-TIF1-Ab-positive patients were more likely to develop ovarian cancer than the anti-TIF1-Ab-negative patients: 19% vs. 2%. Older anti-TIF1-Ab-positive patients were also at a significantly greater risk of developing cancer; no anti-TIF1-Ab-positive patients younger than 39 years old received a cancer diagnosis. This finding suggests that older patients may benefit from cancer screenings, according to the study.

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“Given that older age of IIM onset is associated with [cancer-associated myositis] regardless of autoantibody positivity, and anti-TIF1-Ab positivity confers an increased risk, detailed screening for cancer in anti-TIF1-Ab-positive patients ≥39 years of age is advocated,” the researchers wrote.

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Source: Rheumatology