Prognostic factors for patients with cancer-associated dermatomyositis: a retrospective, multicenter cohort study of 73 patients.

IF 4.7 2区医学 Q1 RHEUMATOLOGY Rheumatology Pub Date : 2024-11-26 DOI:10.1093/rheumatology/keae629

Alexandre Teboul, Yves Allenbach, Florence Tubach, Lisa Belin, Charles Cassius, Juliette Demortier, Antoine Dossier, Caroline Faucon, Camille Kasser, Arsène Mekinian, Grégoire Monseau, Maxime Fouchard, Estel Chambrelan, Manuelle Viguier, Nicolas Kluger, Thibault Mahévas, Blanche Bergeret, Claude Bachmeyer, Cédric Lenormand, Claire Hotz, Emmanuelle Diaz, Nadège Cordel, Olivier Benveniste, Didier Bessis, Jean-David Bouaziz, François Chasset

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Abstract

Objectives: To investigate factors associated with dermatomyositis (DM) complete clinical response and overall survival with a focus on the use of immunosuppressive therapies in patients with cancer-associated DM.

Methods: We performed a multicentre, retrospective cohort study. Multivariable survival analyses used a Cox model with time-dependent covariates and adjustments with inverse probability censoring weighting.

Results: We included 73 patients with cancer-associated DM. Median follow-up was 3.92 years. Overall, 40 (54.8%) patients achieved cancer remission, with DM complete clinical response in 28/40 (70.0%). DM complete clinical response was associated with cancer remission (hazard ratio [HR] 2.46, 95%CI [1.13-5.32]) and younger age (HR 0.68, 95%CI [0.49-0.95]). Risk of mortality was associated with sustained cancer activity (HR 12.93, 95% CI [2.42-69.25]), male sex (HR 2.82, 95% CI [1.19-6.70]), and older age (HR 1.86, 95% CI [1.26-2.79]) but not sustained DM activity (HR 0.40, 95%CI [0.13-1.26]). Oral corticosteroids use was a protective factor only on univariate analysis (HR 0.18, 95% CI [0.08-0.42]).

Conclusion: This study provides strong evidence of a significant association between the evolutions of DM and cancer, both in terms of overall survival and DM complete clinical response. Immunosuppressive treatments for DM were not significantly associated with mortality.

Trial registration: ClinicalTrials.gov, NCT04637672.

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癌症相关皮肌炎患者的预后因素：一项对 73 名患者进行的多中心队列回顾性研究。

目的：研究皮肌炎（DM）完全临床应答和总生存率的相关因素，重点关注癌症相关DM患者使用免疫抑制疗法的情况：研究皮肌炎（DM）完全临床应答和总生存率的相关因素，重点关注癌症相关DM患者使用免疫抑制疗法的情况：我们进行了一项多中心、回顾性队列研究。多变量生存分析采用了带有时间依赖性协变量的 Cox 模型，并使用反概率普查加权法进行了调整：我们纳入了 73 名癌症相关 DM 患者。中位随访时间为 3.92 年。总体而言，40 例（54.8%）患者的癌症得到了缓解，其中 28/40 例（70.0%）患者的 DM 临床反应完全。DM完全临床应答与癌症缓解（危险比 [HR] 2.46，95%CI [1.13-5.32]）和年龄较小（HR 0.68，95%CI [0.49-0.95]）有关。死亡风险与持续的癌症活动（HR 12.93，95% CI [2.42-69.25]）、男性（HR 2.82，95% CI [1.19-6.70]）和年龄（HR 1.86，95% CI [1.26-2.79]）有关，但与持续的糖尿病活动（HR 0.40，95% CI [0.13-1.26]）无关。口服皮质类固醇仅在单变量分析中是一个保护因素（HR 0.18，95% CI [0.08-0.42]）：这项研究提供了强有力的证据，证明无论是从总生存率还是从 DM 完全临床反应来看，DM 的发展与癌症之间都存在着显著的关联。试验注册：试验注册：ClinicalTrials.gov，NCT04637672。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

7.30%

发文量

1091

审稿时长

2 months

期刊介绍： Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.