The neural network as a predictor of cancer in patients with inflammatory myopathies

ObjectiveTo define potential factors that could predict concomitant neoplastic diseases in patients diagnosed with PM/DM, which could inform screening decisions.MethodsTwo researchers independently reviewed articles from Pubmed (MEDLINE), EMBASE, Cochrane Plus Library and ISI Web of Knowledge with no restrictions on study design or language. Given that some of the studies combined PM and DM patients as research subjects while others included only DM patients, data were subjected to meta-analyses for all combined PM/DM studies and studies that included only DM patients to obtain informative results.ResultsFor PM/DM patients, the following factors are all associated with an increased risk of malignancy: older age, age greater than 45, male sex, dysphagia, cutaneous necrosis, cutaneous vasculitis, rapid onset of myostis (<4 weeks), elevated CK, higher ESR, higher CRP levels. Several factors were associated with lower-than-average risk, including the presence of ILD, arthritis/arthralgia, Raynaud's syndrome, or anti-Jo-1 antibody. For DM patients, results indicated an increased risk of malignancy with older age, male sex, the presence of cutaneous necrosis, elevated ESR (>35 mm/hr), higher CRP levels, or anti-p155 antibody. In addition, the presence of anti-ENA antibodies seem to be related to reduced risk of malignancy.ConclusionAwareness and implementation of early-stage cancer screening in PM/DM patients who have these identified factors – such as being older than 45, male sex, cutaneous necrosis, cutaneous vasculitis – are of crucial importance from public health and clinical perspectives and provide insight into the etiopathogenesis of CAM.

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“…The estimate for the five studies[20], [27], [31], [36], [37] involving DM patients only was 1.24 (95% CI: 0.76 to 2.02).…”

Section: Resultsmentioning

confidence: 99%

“…Of the included studies, 13 studies [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] considered age as a variable. Out of these 13 studies, two studies [29] , [30] provided age group-specific data: data for patients younger than 45 and data for patients 45 and older.…”

Section: Resultsmentioning

confidence: 99%

Factors Predicting Malignancy in Patients with Polymyositis and Dermatomyostis: A Systematic Review and Meta-Analysis

et al. 2014

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“…Clinical research studies have shown that older age, male sex, dysphagia, and skin manifestations, such as skin necrosis, periungual erythema, and the 'V' or 'shawl' sign, are associated with occult malignancy in patients with myositis. Refractory or recurrent disease and certain capillaroscopic patterns have also been related with cancerassociated myositis [8][9][10]11 ]. In contrast, the presence of interstitial lung disease seems to be protective for the development of cancer, although a few cases of malignancy in patients with interstitial lung disease and anti-Jo-1 antibodies have been reported [12][13][14].…”

Section: Epidemiological Datamentioning

confidence: 97%

“…An absence of autoantibodies seems to be predictive of a high risk of occult malignancy, whereas the presence of antisynthetase antibodies seems to have a protective value against cancer [8][9][10].…”

Section: Epidemiological Datamentioning

confidence: 99%

Malignancy and myositis: novel autoantibodies and new insights

Selva-O’Callaghan

Trallero-Araguás²,

Grau-Junyent³

et al. 2010

Current Opinion in Rheumatology

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“…It is well-recognized that inflammatory myopathy, mainly dermatomyositis in patients over the age of 50 years, is strongly associated with a wide range of cancers [74,75] and there are concerns regarding the potential development of malignancy following TNF-α blockade. A clinical and immunological approach to this subject by use of neural networks has recently been described [76] and could be useful for defining the patients at highest risk. Future studies will determine the…”

Section: Referencesmentioning

confidence: 99%

Specific Biologic Therapy with Tumor Necrosis Factor Inhibitors in Patients with Inflammatory Myopathy

Labrador-Horrillo¹,

Tarrés

2005

CRR

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Tumor necrosis factor (TNF) and TNF receptors are members of a family of molecules with important regulatory functions that include cellular activation and apoptosis. Neutralization of TNFα has proven to be effective in a variety of inflammatory disorders and autoimmune diseases such as rheumatoid arthritis and Crohn's disease. Treatment of inflammatory myopathies remains a challenge, especially in the case of refractory disease. Elevation of soluble tumor necrosis factor observed in patients with polymyositis/dermatomyositis has led to the suggestion that biologic therapies may be useful in these patients, although experience with anti-TNF agents is still limited. The aim of this mini-review is to summarize the biological bases for treatment of these patients with TNFα inhibitors, to look at the risks and benefits of this therapy -malignancy in patients with a recognized paraneoplastic association and infection versus therapeutic response in refractory myositisand to review the results of the currently reported cases.

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The neural network as a predictor of cancer in patients with inflammatory myopathies

Cited by 15 publications

References 9 publications

Factors Predicting Malignancy in Patients with Polymyositis and Dermatomyostis: A Systematic Review and Meta-Analysis

Factors Predicting Malignancy in Patients with Polymyositis and Dermatomyostis: A Systematic Review and Meta-Analysis

Malignancy and myositis: novel autoantibodies and new insights

Specific Biologic Therapy with Tumor Necrosis Factor Inhibitors in Patients with Inflammatory Myopathy

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