Associations of mutation profiles with clinical outcomes among metastatic colorectal cancer patients at the United States-Mexico border.

e15519 Background: The incidence of CRC among Hispanics living in the USA varies according to their country of origin, supports the idea that differences in ancestry may contribute to the differences in the incidence of CRC. Moreover, Hispanics-Latino(HL) patients usually present with a more advanced stage and have a higher mortality rate compared to other ethnic cohorts. Although it is unknown, the incidence of CRC has been substantially increasing among younger Hispanics. We sought to characterize the tumor mutation profile of mCRC patients and associate with clinical outcomes among Hispanic population. Methods: We retrospectively collected the data from next generation sequencing of 49 patients with metastatic CRC (treated at TTUHSC from 2012 to 2020. We identified the most frequent alterations in our study sample and associated with the clinical outcomes. Association analyses were performed using chi square test, unpaired t-test, log rank test and the Cox proportional hazards regressions. Results: Of 49 patients with mCRC, the average age of patients at the time of diagnosis was 57 years with 98% Hispanic, and 32(65%) male. Most of the patients had stage IV disease (98%) and left side CRC (31, 67%). In our study cohort, the most commonly mutated genes identified as APC (37/11, 77.08%), TP53 (29/19, 60.42%), KRAS (23/25, 47.92%), NOTCH 12/36 (25.00%), BRCA 1&2 11/37 (22.92%) and FLT1 11/37 (22.92%). None of the identified mutations were found to be associated with overall survival. However, the presence of the FLT1 mutation was associated with a reduced risk of progression to additional chemotherapy (P=0.031). Compared to the left side CRC, the BRCA mutation appeared slightly higher on the right side of the CRC (p=0.057). In compare to data from larger national and international colon cancer databases ( COSMIC and METABRICS); HL patients showed a significantly higher proportion of frequent mutations. Compared to other ethnic cohorts, HL patients were relatively younger (57 vs. 63 years) and the male to female ratio was observed to be remarkably higher as well (1.77:1 vs. 1.32:1). In our study, the combination of mutations (TP53, APC, and KRAS) was associated with worse clinical outcomes. Our study demonstrated that worse clinical outcomes were correlated with. Conclusions: Our study is the first to characterize the most common genetic alterations among HL patients with mCRC. The most frequent identified mutations including TP53, APC, KRAS, NOTCH, and BRCA were even higher in HL cohort than the national and international databases ( COSMIC and METABRICS). Our data support the motion that molecular drivers of colon cancer might be different in HL patients.

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Pharmacogenetics of Tamoxifen Biotransformation Is Associated With Clinical Outcomes of Efficacy and Hot Flashes

Journal of Clinical Oncology ◽

10.1200/jco.2005.03.3266 ◽

2005 ◽

Vol 23 (36) ◽

pp. 9312-9318 ◽

Cited By ~ 564

Author(s):

Matthew P. Goetz ◽

James M. Rae ◽

Vera J. Suman ◽

Stephanie L. Safgren ◽

Matthew M. Ames ◽

...

Keyword(s):

Clinical Outcomes ◽

Proportional Hazards ◽

Hot Flashes ◽

Disease Free Survival ◽

Metabolic Activation ◽

Cox Proportional Hazards ◽

Rank Test ◽

Buccal Cells ◽

Cancer Trial ◽

Adjuvant Breast Cancer

Purpose Polymorphisms in tamoxifen metabolizing genes affect the plasma concentration of tamoxifen metabolites, but their effect on clinical outcome is unknown. Methods We determined cytochrome P450 (CYP)2D6 (*4 and *6) and CYP3A5 (*3) genotype from paraffin-embedded tumor samples and buccal cells (living patients) in tamoxifen-treated women enrolled onto a North Central Cancer Treatment Group adjuvant breast cancer trial. The relationship between genotype and disease outcome was determined using the log-rank test and Cox proportional hazards modeling. Results Paraffin blocks were obtained from 223 of 256 eligible patients, and buccal cells were obtained from 17 living women. CYP2D6 (*4 and *6) and CYP3A5 (*3) genotypes were determined from 190, 194, and 205 patient samples and in 17 living women. The concordance rate between buccal and tumor genotype was 100%. Women with the CYP2D6 *4/*4 genotype had worse relapse-free time (RF-time; P = .023) and disease-free survival (DFS; P = .012), but not overall survival (P = .169) and did not experience moderate to severe hot flashes relative to women heterozygous or homozygous for the wild-type allele. In the multivariate analysis, women with the CYP2D6 *4/*4 genotype still tended to have worse RFS (hazard ratio [HR], 1.85; P = .176) and DFS (HR, 1.86; P = .089). The CYP3A5*3 variant was not associated with any of these clinical outcomes. Conclusion In tamoxifen-treated patients, women with the CYP2D6 *4/*4 genotype tend to have a higher risk of disease relapse and a lower incidence of hot flashes, which is consistent with our previous observation that CYP2D6 is responsible for the metabolic activation of tamoxifen to endoxifen.

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Utilization and outcomes of primary tumor surgery for stage IV colon cancer in the United States: A population-based study.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.3542 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 3542-3542

Author(s):

Yvonne Sada ◽

Zhigang Duan ◽

Hashem El-Serag ◽

Jessica Davila

Keyword(s):

Colon Cancer ◽

Logistic Regression ◽

Primary Tumor ◽

Proportional Hazards ◽

Stage Iv ◽

The United States ◽

Cox Proportional Hazards ◽

Tumor Surgery ◽

Cancer Specific Survival ◽

Co Morbidity

3542 Background: Stage IV colon cancer treatment may include resection of the primary tumor. Current use of primary tumor surgery (PTS) in clinical practice is unknown. This study examined utilization and determinants of PTS and evaluated its effect on survival. Methods: Using national Surveillance, Epidemiology, and End Results registry data, stage IV colon cancer patients diagnosed from 1998-2008 were identified. Data on demographics, PTS, and tumor features were collected. Temporal changes in receipt of PTS were examined over 3 periods (1998-2000, 2001-2004, 2005-2008). Multiple logistic regression was used to identify significant determinants of PTS. 1- and 3-year cancer-specific survival was calculated in PTS and non-PTS patients. Cox proportional hazards models examined the effect of PTS on mortality risk. Results: 16,029 patients were identified. Median age was 69 (IQR: 57-78), and 50% were male. Approximately 67% of patients received PTS. Receipt of PTS significantly declined from 72% in 1998-2000 to 68% in 2001-2004, and 63% in 2005-2008 (p<0.01). Results from the logistic regression analysis showed that patients who were younger, white, married, had right sided cancer and higher tumor grade were more likely to receive PTS (all p<0.01). The 1- and 3-year survival was higher in patients who received PTS compared with those who did not (1-year: 55% (95% CI: 54-56) vs. 24% (95% CI: 23-26); 3-year: 19% (95% CI: 19-20) vs. 4% (95%CI: 3.4-4.9)). Adjusted for demographics and tumor features, risk of mortality was 54% (HR=0.46; 95% CI: 0.44-0.48) lower in patients who received PTS than those without PTS. Recent year of diagnosis (HR=0.88; 95% CI: 0.75-0.80) and being married (HR=0.90, 95% CI: 0.86-0.95) were associated with lower mortality. Older age (HR=1.48; 95% CI: 1.39-1.56), black race (HR=1.09; 95% CI: 1.03-1.15), right sided cancer (HR=1.21; 95% CI: 1.17-1.26), and poorly differentiated tumors (HR= 1.62; 95% CI: 1.46-1.80) were associated with increased mortality. Conclusions: PTS utilization for stage IV colon cancer has significantly declined, yet survival was higher in patients who received PTS. However, these findings are limited by the absence of co-morbidity and chemotherapy data.

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Hypertension (HTN) as a potential biomarker of efficacy in patients (pts) with gastrointestinal stromal tumor (GIST) treated with sunitinib (SU).

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.38 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 38-38 ◽

Cited By ~ 1

Author(s):

S. George ◽

T. Lechner ◽

S. Li ◽

D. P. Cohen ◽

G. D. Demetri

Keyword(s):

Clinical Outcomes ◽

Tyrosine Kinases ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Rank Test ◽

Significant Independent Predictor ◽

Hazards Model ◽

Potential Biomarker

38 Background: HTN is a class effect of VEGF signaling pathway inhibitors. SU is a multitargeted inhibitor of VEGFRs and other receptor tyrosine kinases. Associations between SU-induced HTN and efficacy endpoints (OS, PFS, TTP, and ORR) in pts with imatinib-resistant/intolerant GIST from 2 prospective clinical trials were investigated retrospectively. Methods: This analysis included pooled data from 319 pts who received SU and had post-baseline blood pressure (BP) data available. Tumor response data were based on investigator assessments. Most pts (87%) received SU 50 mg/d on the standard 4-wk-on/2-wk-off schedule. BP was measured on the first and last day of dosing in each treatment cycle at a minimum. HTN was defined as max or mean SBP ≥ 140 or DBP ≥ 90 mmHg. OS, PFS, and TTP were estimated by Kaplan—Meier methods and compared between pts with vs. without HTN using the log-rank test. The influence of prognostic risk factors was analyzed using a Cox proportional hazards model. Results: 233 and 187 pts (73% and 59%) had ≥ 1 HTN episode as defined by max SBP and DBP, respectively. Efficacy results significantly favored pts who developed HTN on SU based on max SBP or DBP (eg, median OS for pts with HTN [max SBP] was 89.4 weeks vs. 53.1 weeks for pts without HTN [p = 0.0001]). Using HTN onset as a time-dependent covariate, HTN defined by max DBP was a significant predictor of prolonged TTP and PFS, and HTN defined by both max SBP and DBP was a significant predictor of prolonged OS (p < 0.05). In multivariate analysis, HTN defined by max SBP or DBP was a significant independent predictor of improved OS, PFS, and TTP (p < 0.0001). Analysis of any-grade and grade ≥3 cerebrovascular, ocular, cardiac, and renal AEs in pts with/without HTN is ongoing and will be presented. Clinical outcomes were not compromised in pts treated with anti-HTN medications. Conclusions: SU-associated HTN was significantly and independently associated with improved clinical outcomes, supporting the hypothesis that HTN is a biomarker for antitumor efficacy in pts with GIST treated with SU. Serial BP monitoring and standard use of anti-HTN medications, which were not shown to compromise efficacy, are recommended during SU therapy. [Table: see text]

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A tertiary cancer center experience with yttrium-90 radioembolization in hepatocellular carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.443 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 443-443

Author(s):

Kerry Schaffer ◽

Marcus Smith Noel ◽

Aram F. Hezel ◽

Alan W. Katz ◽

Ashwani Sharma ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Proportional Hazards ◽

Cox Model ◽

The United States ◽

Cox Proportional Hazards ◽

Rank Test ◽

Bridge To Transplant ◽

Kaplan Meier ◽

Pugh Class

443 Background: Local-regional radioembolization with Yitrium-90 (Y-90) has become standard practice for patients with hepatocellular carcinoma (HCC) either as a bridge to transplant, or for local disease control. Outcomes data in the United States are limited and here we review our institutional experience with Y-90 radioembolization. Methods: We retrospectively reviewed charts from 70 patients with HCC who were treated with Y-90 from May 2010- January 2014. Clinical variables including Child-Pugh class and CLIP score were extracted from patient records. The Cox proportional hazards model was used to determine prognostic factors, and Kaplan-Meier curves were used to determine PFS and OS. Results: Median age was 61 (range 43-82), 79% Caucasian, 84% male, and 79% Child-Pugh class A. Median progression free survival (PFS) was 8.4 months (95% CI 6-10.7) and overall survival (OS) was 14.2 months (95% CI 9.7-21). Overall survival significantly differed by Child -Pugh score (p= 0.009), CLIP score (p=0.003), and presence of portal vein thrombosis (PVT) (p=0.0384), based on the log-rank test comparing Kaplan-Meier curves. Using univariate Cox proportional hazards models, both elevated baseline AFP, measured on a log scale (HR 1.79, 95% CI 1.32-2.43, p=0.0002) and post Y-90 treatment with sorafenib (HR=2.30, 95% CI 1.07-4.95, p=0.03) were associated with worse mortality. Elevated AFP (HR 2.45, 95% CI 1.73-3.47, p<0.0001) and Child-Pugh score of B (HR 4.83, 95% CI 2.23-10.43, p<0.0001) were associated with worse mortality in a multivariate Cox model adjusting for age and ethnicity. Furthermore, AFP values were significantly higher in the 10 patients who died within 4 months of Y-90 (p=0.001), and significantly lower in 7 patients who eventually received a liver transplant (p=0.0002). Conclusions: In patients undergoing treatment with Y-90 radioembolization, Child-Pugh class, CLIP score, presence of PVT, baseline AFP, and sorafenib post Y-90 were significantly associated with overall survival. Median PFS and OS data in this institutional cohort are encouraging. Further prospective studies on Y-90 treatment for HCC are warranted.

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Clinical Implications of Size of Cavities in Patients With Nontuberculous Mycobacterial Pulmonary Disease: A Single-Center Cohort Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab087 ◽

2021 ◽

Vol 8 (3) ◽

Author(s):

Hye-Rin Kang ◽

Eui Jin Hwang ◽

Sung A Kim ◽

Sun Mi Choi ◽

Jinwoo Lee ◽

...

Keyword(s):

Treatment Outcomes ◽

Pulmonary Disease ◽

Clinical Outcomes ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

University Hospital ◽

Study Cohort ◽

National University ◽

Seoul National University ◽

The Impact

Abstract Background The presence of cavities is associated with unfavorable prognosis in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). However, little is known about the characteristics of such cavities and their impact on clinical outcomes. The aim of this study was to investigate the size of cavities and their implications on treatment outcomes and mortality in patients with NTM-PD. Methods We included patients diagnosed with NTM-PD at Seoul National University Hospital between January 1, 2007, and December 31, 2018. We measured the size of cavities on chest computed tomography scans performed at the time of diagnosis and used multivariable logistic regression and Cox proportional hazards regression analysis to investigate the impact of these measurements on treatment outcomes and mortality. Results The study cohort comprised 421 patients (noncavitary, n = 329; cavitary, n = 92) with NTM-PD. During a median follow-up period of 49 months, 118 (35.9%) of the 329 patients with noncavitary and 64 (69.6%) of the 92 patients with cavitary NTM-PD received antibiotic treatment. Cavities >2 cm were associated with worse treatment outcomes (adjusted odds ratio, 0.41; 95% CI, 0.17–0.96) and higher mortality (adjusted hazard ratio, 2.52; 95% CI, 1.09–5.84), while there was no difference in treatment outcomes or mortality between patients with cavities ≤2 cm and patients with noncavitary NTM-PD. Conclusions Clinical outcomes are different according to the size of cavities in patients with cavitary NTM-PD; thus, the measurement of the size of cavities could help in making clinical decisions.

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Colon Cancer Survival Is Associated With Increasing Number of Lymph Nodes Analyzed: A Secondary Survey of Intergroup Trial INT-0089

Journal of Clinical Oncology ◽

10.1200/jco.2003.05.062 ◽

2003 ◽

Vol 21 (15) ◽

pp. 2912-2919 ◽

Cited By ~ 720

Author(s):

T.E. Le Voyer ◽

E.R. Sigurdson ◽

A.L. Hanlon ◽

R.J. Mayer ◽

J.S. Macdonald ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Proportional Hazards ◽

Disease Free Survival ◽

Cox Proportional Hazards ◽

Rank Test ◽

End Points ◽

Intergroup Trial ◽

The Impact

Purpose: To determine the relationship, in patients with adenocarcinoma of the colon, between survival and the number of lymph nodes analyzed from surgical specimens. Patients and Methods: Intergroup Trial INT-0089 is a mature trial of adjuvant chemotherapy for high-risk patients with stage II and stage III colon cancer. We performed a secondary analysis of this group with overall survival (OS) as the main end point. Cause-specific survival (CSS) and disease-free survival were secondary end points. Rates for these outcome measures were estimated using Kaplan-Meier methodology. Log-rank test was used to compare overall curves, and Cox proportional hazards regression was used to multivariately assess predictors of outcome. Results: The median number of lymph nodes removed at colectomy was 11 (range, one to 87). Of the 3,411 assessable patients, 648 had no evidence of lymph node metastasis. Multivariate analyses were performed on the node-positive and node-negative groups separately to ascertain the effect of lymph node removal. Survival decreased with increasing number of lymph node involvement (P = .0001 for all three survival end points). After controlling for the number of nodes involved, survival increased as more nodes were analyzed (P = .0001 for all three end points). Even when no nodes were involved, OS and CSS improved as more lymph nodes were analyzed (P = .0005 and P = .007, respectively). Conclusion: The number of lymph nodes analyzed for staging colon cancers is, itself, a prognostic variable on outcome. The impact of this variable is such that it may be an important variable to include in evaluating future trials.

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Integrating Tumor Stroma Biomarkers With Clinical Indicators for Colon Cancer Survival Stratification

Frontiers in Medicine ◽

10.3389/fmed.2020.584747 ◽

2020 ◽

Vol 7 ◽

Author(s):

Yong Chen ◽

Wenlong Wang ◽

Bo Jiang ◽

Lei Yao ◽

Fada Xia ◽

...

Keyword(s):

Colon Cancer ◽

Proportional Hazards ◽

Malignant Tumors ◽

Tumor Stroma ◽

Tumor Stage ◽

Cox Proportional Hazards ◽

Rank Test ◽

Survival Prognosis ◽

Chemotherapeutic Resistance ◽

Prognosis Prediction

The tumor stroma plays an important role in tumor progression and chemotherapeutic resistance; however, its role in colon cancer (CC) survival prognosis remains to be investigated. Here, we identified tumor stroma biomarkers and evaluated their role in CC prognosis stratification. Four independent datasets containing a total of 1,313 patients were included in this study and were divided into training and testing sets. Stromal scores calculated using the estimation of stromal and immune cells in malignant tumors using expression data (ESTIMATE) algorithm were used to assess the tumor stroma level. Kaplan-Meier curves and the log-rank test were used to identify relationships between stromal score and prognosis. Tumor stroma biomarkers were identified by cross-validation of multiple datasets and bioinformatics methods. Cox proportional hazards regression models were constructed using four prognosis factors (age, tumor stage, the ESTIMATE stromal score, and the biomarker stromal score) in different combinations for prognosis prediction and compared. Patients with high stromal scores had a lower overall survival rate (p = 0.00016), higher risk of recurrence (p < 0.0001), and higher probability of chemotherapeutic resistance (p < 0.0001) than those with low scores. We identified 16 tumor stroma biomarkers and generated a new prognosis indicator termed the biomarker stromal score (ranging from 0 to 16) based on their expression levels. Its addition to an age/tumor stage-based model significantly improved prognosis prediction accuracy. In conclusion, the tumor stromal score is significantly negatively associated with CC survival prognosis, and the new tumor stroma indicator can improve CC prognosis stratification.

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Clinical Implications of Size of Cavities in Patients With Nontuberculous Mycobacterial Pulmonary Disease: A Single-Center Cohort Study

10.21203/rs.3.rs-124209/v1 ◽

2020 ◽

Author(s):

Hye-Rin Kang ◽

Eui Jin Hwang ◽

Sung A Kim ◽

Sun Mi Choi ◽

Jinwoo Lee ◽

...

Keyword(s):

Treatment Outcomes ◽

Pulmonary Disease ◽

Clinical Outcomes ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

University Hospital ◽

Study Cohort ◽

Poor Prognostic Factor ◽

National University ◽

The Impact

Abstract BackgroundThe presence of cavities is a poor prognostic factor in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). However, little is known about the characteristics of such cavities and their impact on clinical outcomes. The aim of this study is to investigate the size of cavities and their implications on treatment outcomes and mortality in patients with NTM-PD.MethodsWe included patients diagnosed with NTM-PD at Seoul National University Hospital between 1 January 2007 and 31 December 2018. We measured the size of cavities on chest computed tomography scans performed at the time of diagnosis, and used multivariable logistic regression and Cox-proportional hazards regression analysis to investigate the impact of these measurements on treatment outcomes and mortality. ResultsThe study cohort comprised 421 patients (non-cavitary, n=329; cavitary, n=92) with NTM-PD. During a median follow-up period of 49 months, 118 (35.9%) of the 329 patients with non-cavitary and 64 (69.6%) of the 92 patients with cavitary NTM-PD received antibiotic treatment. Cavities >2 cm were associated with worse treatment outcomes (adjusted odds ratio, 0.38; 95% confidence interval [CI], 0.16–0.86) and higher mortality (adjusted hazard ratio, 2.50; 95% CI, 1.04–6.02), while there was no difference in treatment outcomes and mortality between patients with cavities <2 cm and patients with non-cavitary NTM-PD. ConclusionsClinical outcomes are different according to the size of cavities in patients with cavitary NTM-PD; thus the measurement of the size of cavities could help in making clinical decisions.

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The role of adjuvant radiotherapy in pathologically node positive prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.28 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 28-28

Author(s):

Naresh Jegadeesh ◽

Yuan Liu ◽

Chao Zhang ◽

Jim Zhong ◽

Theresa Wicklin Gillespie ◽

...

Keyword(s):

Prostate Cancer ◽

Proportional Hazards ◽

Multivariable Analysis ◽

Surgical Margin ◽

The United States ◽

Cox Proportional Hazards ◽

Rank Test ◽

Positive Surgical Margin ◽

Cancer Data

28 Background: The postoperative management of prostate cancer with regional lymph nodal involvement (LNI) is controversial. Prospective evidence to guide the role of radiotherapy (RT) in this setting does not exist. Randomized studies demonstrate an improvement in disease-related outcomes with adjuvant RT in high-risk patients without LNI following prostatectomy (RP). Retrospective evidence supports the selective use of RT with LNI following extended pelvic lymph node dissection. It is unclear if this experience is generalizable to practice in the United States where extended dissection is uncommon. We sought to identify patients with LNI who may derive a survival benefit following adjuvant RT. Methods: The National Cancer Data Base was queried for M0 patients with prostate adenocarcinoma who underwent RP with pathologic LNI. Adjvuant RT was defined as delivered within 6 months following RP. Kaplan-Meier, log-rank test, and multivariable Cox proportional hazards regression were performed with overall survival (OS) as the primary outcome. Propensity score matching (PSM) was employed to further reduce treatment selection bias. Results: 7,902 patients diagnosed between 2003-2011 were eligible for analysis; 1,439 (18.2%) received RT. RT was more frequently employed in patients with lower Charlson-Deyo Comorbidity Score, higher T stage, <5 nodes examined, ≥50% nodal positivity ratio, Gleason 8-10, ≥20 PSA, positive surgical margin, and <65 years of age (all p < 0.05). Five year OS was 87.6% vs. 85% in those receiving RT vs. not (p = 0.075). With androgen deprivation (ADT) (n = 3,265), 5-year OS was 87.2% vs. 82.7% in those receiving RT vs. not (p = 0.004). In multivariable analysis, the use of RT was independently associated with improved OS (HR 0.73, 95% CI 0.59-0.89, p = 0.002). 894 remained in each cohort following PSM. In this analysis, RT remained associated with OS (HR 0.66, 95% CI 0.51-0.85, p = 0.002). Conclusions: Adjuvant RT was associated with improved OS following RP in patients with LNI in this large generalizable retrospective analysis. This effect appears stronger in those receiving ADT. This series is the largest describing adjuvant RT in this population. In the absence of prospective evidence, these results may help guide therapy in this setting.

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Epilepsy as a Comorbidity in Polymyositis and Dermatomyositis—A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083983 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3983

Author(s):

Ella Nissan ◽

Abdulla Watad ◽

Arnon D. Cohen ◽

Kassem Sharif ◽

Johnatan Nissan ◽

...

Keyword(s):

Proportional Hazards ◽

Cross Sectional Study ◽

Cox Proportional Hazards ◽

Categorical Variables ◽

Rank Test ◽

Control Group ◽

Multivariable Logistic Regression Analysis ◽

Positive Trend ◽

Continuous Variables ◽

Cross Sectional

Polymyositis (PM) and dermatomyositis (DM) are autoimmune-mediated multisystemic myopathies, characterized mainly by proximal muscle weakness. A connection between epilepsy and PM/DM has not been reported previously. Our study aim is to evaluate this association. A case–control study was conducted, enrolling a total of 12,278 patients with 2085 cases (17.0%) and 10,193 subjects in the control group (83.0%). Student’s t-test was used to evaluate continuous variables, while the chi-square test was applied for the distribution of categorical variables. Log-rank test, Kaplan–Meier curves and multivariate Cox proportional hazards method were performed for the analysis regarding survival. Of the studied 2085 cases, 1475 subjects (70.7%) were diagnosed with DM, and 610 patients (29.3%) with PM. Participants enrolled as cases had a significantly higher rate of epilepsy (n = 48 [2.3%]) as compared to controls (n = 141 [1.4%], p < 0.0005). Using multivariable logistic regression analysis, PM was found only to be significantly associated with epilepsy (OR 2.2 [95%CI 1.36 to 3.55], p = 0.0014), whereas a non-significant positive trend was noted in DM (OR 1.51 [95%CI 0.99 to 2.30], p = 0.0547). Our data suggest that PM is associated with a higher rate of epilepsy compared to controls. Physicians should be aware of this comorbidity in patients with immune-mediated myopathies.

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