AB0778 Clinical characteristics and prognosis of polymyositis and dermatomyositis associated with malignancy: a 25-year retrospective study. (12th June 2018)

• Record Type: Journal Article
• Authors: Motomura, K.; Yamashita, H.; Yamada, S.; Takahashi, Y.; Kaneko, H.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1523
• Page End: 1523
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.4059
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Previous studies indicate that malignancies in polymyositis (PM) or dermatomyositis (DM) patients are associated with high mortality. Hence, it becomes important clinically to identify patients who are at high risk of developing malignancy. However, previous studies to characterise such risk factors for malignancy in patients with PM and DM were small size or the findings ware not conclusive. Objectives: This study investigated factors predictive of malignancy and prognosis in patients with PM and DM. Methods: We conducted a retrospective study of PM and DM patients who were inpatients at our hospital between January 1992 and September 2016. The diagnosis of PM or DM was made according to Bohan and Peter criteria. The collected data included gender, age at onset, laboratory test results at presentation, clinical features and complications in all progress. Past history of hypertension or diabetes mellitus was determined upon diagnosis of myositis. All patients in this study were followed from the baseline visit until loss of follow-up or death or otherwise until censor date 1 September 2017. Fisher exact test and Mann-Whitney U test were used for group comparisons. Univariate and multivariate analysis of the predictors of malignancy associated with PM or DM were performed by logistic regression to identify independent risk factors. Patient survival was analysed by using Kaplan-Meier curve and log-rank test. Results: Among 134 patients, 29 had cancer diagnosed between 2 years prior and 3 years following identification of PM or DM. Esophageal cancer (n=5, 14.7%) and lung cancer (n=5, 14.7%) were the most frequent. Univariate analysis showed that male sex (55.2% vs 23.8%, p=0.003), older age (64.6±11.3 vs 53.4±16.5, p<0.001), past history of diabetes mellitus (28.6% vs 2.9%, p<0.001), dysphagia (41.4% vs 17.3%, p=0.01) and absence of interstitial lung disease (37.9% vs 64.8%, p=0.01), arthralgia (17.2% vs 47.1%, p=0.005) and the Raynaud phenomenon (3.4% vs 23.1%, p=0.02) were associated with increased malignancy. Multivariate analysis showed that independent factors included male sex (OR=3.65, p=0.03), older age (OR=1.05, p=0.02), past history of diabetes mellitus (OR=10.4, p=0.005) and absence of interstitial lung disease (OR=0.25, p=0.03) (table 1). Survival was significantly lower in patients with malignancy than in patients without malignancy (p<0.001). Conclusions: This study is the first to associate a past history of diabetes mellitus with malignancy; 28.6% of PM or DM patients with malignancy had diabetes mellitus whereas 7.3 percent of cancer patients had diabetes mellitus. Reference: [1] J.wang, G.Guo, G. Chen, et al. Br J Dermatol. 2013; 169(4): 838–847 Disclosure of Interest: None declared