High risk of cancer in autoimmune necrotizing myopathies: usefulness of myositis specific antibody

• Published in: Brain (London, England : 1878) Vol. 139; no. 8; pp. 2131 - 2135
• Main Authors: Allenbach, Yves, Keraen, Jeremy, Bouvier, Anne-marie, Jooste, Valérie, Champtiaux, Nicolas, Hervier, Baptiste, Schoindre, Yoland, Rigolet, Aude, Gilardin, Laurent, Musset, Lucile, Charuel, Jean-Luc, Boyer, Olivier, Jouen, Fabienne, Drouot, Laurent, Martinet, Jeremie, Stojkovic, Tanya, Eymard, Bruno, Laforêt, Pascal, Behin, Antony, Salort-Campana, Emmanuelle, Fain, Olivier, Meyer, Alain, Schleinitz, Nicolas, Mariampillai, Kuberaka, Grados, Aurelie, Benveniste, Olivier
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.08.2016
• Subjects: Adult; Aged; Autoantibodies - blood; Autoimmune Diseases - blood; Autoimmune Diseases - epidemiology; Comorbidity; Dermatomyositis - blood; Dermatomyositis - epidemiology; Female; Humans; Hydroxymethylglutaryl CoA Reductases - immunology; Life Sciences; Male; Middle Aged; Muscular Diseases - blood; Muscular Diseases - epidemiology; Myositis - immunology; Neoplasms - blood; Neoplasms - epidemiology; Neurons and Cognition; auto-antibodies; polymyositis; cancer; necrotizing autoimmune myopathies; Polymyositis; Autoantibodies; Dermatomyositis; Inflammatory myopathies; Pathological features; Reductase
• ISSN: 0006-8950; 1460-2156; 1460-2156
• DOI: 10.1093/brain/aww054

Cancer can occur in patients with inflammatory myopathies. This association is mainly observed in dermatomyositis, and myositis-specific antibodies have allowed us to delineate patients at an increased risk. Malignancy is also reported in patients with necrotizing autoimmune myopathies, but the risk remains elusive. Anti-signal recognition particle or anti-HMGCR antibodies have been specifically associated with necrotizing autoimmune myopathies. We aimed at screening the incidence of cancer in necrotizing autoimmune myopathies. A group of patients (n = 115) with necrotizing autoimmune myopathies with or without myositis-specific antibodies was analysed. Malignancy occurred more frequently in seronegative necrotizing autoimmune myopathies patients and in HMGCR-positive patients compared to anti-signal recognition particle positive patients. Synchronous malignancy was diagnosed in 21.4% and 11.5% of cases, respectively, and incidence of cancer was higher compared to the general population in both groups. No specific type of cancer was predominant. Patients suffering from a synchronous cancer had a decreased median survival time. Cancer screening is necessary in seronegative necrotizing autoimmune myopathies and in HMGCR-positive patients but not in anti-signal recognition particle-positive patients.