RESEARCH - Antimalarials [Plaquenil] may influence the risk of malignancy in SLE

January 6, 2007

Ann Rheum Dis. Published Online First: 4 January 2007.

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Concise Report

Antimalarials may influence the risk of malignancy in systemic lupus

erythematosus

G Ruiz-Irastorza 1*, A Ugarte 1, M-V Egurbide 1, M Garmendia 1, J-I Pijoan

1, A ez-Berriotxoa 1 and C Aguirre 1

1 Hospital de Cruces-University of the Basque Country, Spain

Abstract

Background: Recent studies suggest that antimalarials have antineoplastic

properties.

Objective: To investigate whether antimalarials decrease the risk of cancer

in SLE.

Methods: Observational prospective cohort study. 235 patients included in

the study at the time of diagnosis (ACR criteria). The end point was the

diagnosis of cancer. Kaplan-Meier free-of-cancer survival curves for

patients treated and non-treated with antimalarials were compared. A

proportional hazards model was fitted, with cancer as the dependent

variable. Age at diagnosis, gender, treatment with azathioprine,

cyclophosphamide and methotrexate, smoking, SDI 6 months after diagnosis,

year of diagnosis and treatment with antimalarials were entered as

independent variables.

Results: 209 patients (89%) were women. 233 patients (99%) were white. Mean

(SD) age at diagnosis was 37(16) years. Median follow-up was 10 years (range

1- 31). 156 patients (66%) ever received antimalarials. 2/156 ever (1.3%)

vs. 11/79 never treated patients (13%) had cancer (p<0.001). Cumulative

free-of-cancer survival in treated and untreated patients was 0.98 vs. 0.73,

respectively (p=0.0003). Adjusted HR for cancer among antimalarials users

vs. non-users was 0.15 (95%CI 0.02- 0.99).

Conclusions: This study launches the hypothesis of a protective action of

antimalarials against cancer in patients with SLE. This effect should be

confirmed in larger multicentric studies.

Not an MD

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