Polymyositis and dermatomyositis as a risk of developing cancer

Jakubaszek, Michał; Kwiatkowska, Brygida; Maślińska, Maria

doi:10.5114/reum.2015.51510

Cited by 52 publications

(68 citation statements)

References 18 publications

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“…No MSAs associated with IMNM or AsyS were detected. Finally, edematous myositis was also frequently associated with malignancy, in the same range of other DM patients (16,27,37), while this risk is considered lower in other myositis subgroups.…”

Section: Discussionmentioning

confidence: 84%

Edematous myositis: a clinical presentation first suggesting dermatomyositis diagnosis

et al. 2020

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Aims: Edema of the limbs is uncommon in idiopathic inflammatory myopathies (IIM). The few reported cases have been associated with severe and refractory dermatomyositis (DM), sometimes in association with cancers. We aimed to determine if edematous myositis is a homogeneous subtype based on clinical, serological and pathological features. Methods: This is a retrospective observational study performed between 2008 and 2015 in the French national referral center for myositis. All adult patients with an inflammatory muscle biopsy and upper limbs edema were included as well as IIM cases without limb edema as controls. Clinical, biological and pathological features were collected. Results: Seventeen edematous myositis were included and compared to 174 IIM without edema, including 50 DM controls. Edema was the first manifestation in 23% of patients. Muscle weakness was severe and symmetric, 71% of patients presented dysphagia and a restrictive ventilatory pattern was found in 40%. Fifty‐two percent of patients had a typical DM skin rash and 23% had cancer within 3 years of diagnosing myositis. Fifty‐three percent of patients presented a myositis specific antibody and only DM‐specific antibodies were detected. Classic pathological DM features (perifascicular atrophy, perifascicular/perimysial perivascular inflammation) were uncommon but capillary C5b‐9 deposition and MxA expression were seen in 79% and 73% of cases, respectively. A perimysial edema was found in 82% of cases. Seventeen percent of patients died (median follow up of 18 months). Edematous myositis demonstrated more marked capillary C5b‐9 deposition compared to IIM controls. There was no clinical, biological or pathological difference with DM controls except for limb edema. Conclusion: Our study underlines that limb edema could be a symptom of IIM and that edematous myositis are mostly DM. The vasculopathy seems to play a key role in its pathophysiology. Limb edema associated with muscle impairment should suggest the diagnosis of DM in clinical settings.

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Section: Discussionmentioning

confidence: 84%

Edematous myositis: a clinical presentation first suggesting dermatomyositis diagnosis

et al. 2020

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“…Dermatomyositis and polymyositis increase the likelihood of developing cancer by six and twofold, respectively,1 making appropriate investigation a priority, especially in patients with relevant risk factors 2…”

Section: Discussionmentioning

confidence: 99%

Dysphagia and a rash

McFarlane

Disney

2018

BMJ

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“…Last, we identified several additional comorbidities associated with cancer or its treatment (haemolytic anemia, glomerulonephritis, Grave’s disease, multiple sclerosis, myasthenia gravis, myocarditis, polymyositis, dermatomyositis, rheumatic fever and heart disease, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, human immunodeficiency virus, hepatitis C, Crohn’s disease, Parkinson’s disease, and epilepsy). [42–45] The specific codes used to create these measures are available in a footnote on Table 1.…”

Section: Methodsmentioning

confidence: 99%

Effects of Transitioning to Medicare Part D on Access to Drugs for Medical Conditions among Dual Enrollees with Cancer

et al. 2017

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Objective To evaluate the impact of transitioning from Medicaid to Medicare Part D drug coverage on use of non-cancer treatments among dual enrollees with cancer. Methods We leveraged a representative 5% national sample of all fee-for-service dual enrollees in the U.S. (2004–2007) to evaluate the impact of the removal of caps on the number of reimbursable prescriptions per month (drug caps) under Part D on (1) prevalence and (2) average days’ supply dispensed for antidepressants, antihypertensives, and lipid-lowering agents overall and by race (white, black). Results The removal of drug caps was associated with increased use of lipid-lowering medications (days’ supply: 3.63; 95% CI: 1.57, 5.70). Among blacks in capped states, we observed increased use of lipid-lowering therapy (any use: 0.08 percentage points; 95% CI: 0.05, 0.10; days’ supply: 4.01; 95% CI: 2.92, 5.09), antidepressants (days’ supply: 2.20; 95% CI: 0.61, 3.78) and increasing trends in antihypertensive use (any use: 0.01 percentage points; 95% 0.004, 0.01; days supply: 1.83; 95% CI: 1.25, 2.41). The white-black gap in use of lipid-lowering medications was immediately reduced (−0.09 percentage points; 95% CI: −0.15, −0.04). We also observed a reversal in trends toward widening white-black differences in antihypertensive (level: −0.08 percentage points; 95% CI: −0.12, −0.05; trend: −0.01 percentage points; −0.02, −0.01), and antidepressant use (−0.004; 95% CI: −0.01, −0.0004). Conclusions Our findings suggest that the removal of drug caps under Part D had a modest impact on treatment of hypercholesterolemia overall and may have reduced white-black gaps in use of lipid-lowering and antidepressant therapies.

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Polymyositis and dermatomyositis as a risk of developing cancer

Cited by 52 publications

References 18 publications

Edematous myositis: a clinical presentation first suggesting dermatomyositis diagnosis

Edematous myositis: a clinical presentation first suggesting dermatomyositis diagnosis

Dysphagia and a rash

Effects of Transitioning to Medicare Part D on Access to Drugs for Medical Conditions among Dual Enrollees with Cancer

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