Vasculitis & polymyalgia rheumatica
Malignancy is increased in patients with antineutrophil cytoplasmic antibody-associated vasculitis in China
Main finding · Malignancy after AAV diagnosisResult — go to the resultStandardized incidence ratio 2.24 95% CI 1.68–2.99Authors' conclusion
Malignancy risk is higher in Chinese AAV patients than that in the general population, with a different malignancy spectrum from western countries.
Study context
- Population
- AAV patients diagnosed from 1995 to 2021 at Peking University First Hospital, China, with follow-up more than 12 months529 without preceding/concurrent malignancy
- Participants
- 552 patients
- Exposure
- AAV patients vs general population
- AAVn = 552
- Outcome
- Incidence of malignancy (SIR vs general population)
Methodological detailssingle-centre, standardized incidence ratios (SIR) adjusted for sex, age and follow-up time
- Single-centre
- SIR adjusted for sex, age and follow-up time
Main finding
Malignancy after AAV diagnosis · 4.3 ± 4.2 years post AAV diagnosis
Standardized incidence ratio
2.24
95% CI 1.68–2.99
P < 0.001
Events by group
AAV
43
events
As reported in the abstract
Observational data: associations, not effects.
Further findings
Risk factors for malignancy
- Male gender, HR
- 2.84 (95% CI 1.36-5.96; p = 0.006)
- Older age, per year, HR
- 1.04 (95% CI 1.00-1.07; p = 0.038)
- Significantly associated with increased risk of malignancy
Lung cancer, the leading malignancy (529 patients without preceding or concurrent malignancy)
- Lung cancer SIR vs general population
- 5.01 (95% CI 3.29-7.62)
- Followed by malignancies in the kidney, bladder, ureter and prostate
Malignancy beyond 5 years after AAV diagnosis, cumulative cyclophosphamide dose over 20.0 g (subgroup)
- SIR
- 11.54 (95% CI 4.77-27.93; p < 0.001)
Malignancy within the first 2 years after AAV diagnosis (subgroup)
- Risk still significantly higher than general population; cumulative cyclophosphamide dose not significantly associated with malignancy
Original publication
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