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

2016; Oxford University Press; Volume: 139; Issue: 8 Linguagem: Inglês

10.1093/brain/aww054

1460-2156

Yves Allenbach, Jérémy Keraen, Anne‐Marie Bouvier, Valérie Jooste, Nicolas Champtiaux, B. Hervier, Y. Schoindre, Aude Rigolet, Laurent Gilardin, Lucile Musset, Jean‐Luc Charuel, Olivier Boyer, F. Jouen, Laurent Drouot, J. Martinet, Tanya Stojkovic, B. Eymard, Pascal Laforêt, Anthony Béhin, Emmanuelle Salort‐Campana, O. Fain, Alain Meyer, N. Schleinitz, K. Mariampillai, A. Grados, Olivier Benveniste,

Muscle Physiology and Disorders

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. Cancer occurs frequently in dermatomyositis and is a major cause of mortality. Yves Allenbach et al. report that patients with necrotising auto-immune myopathies also have an increased risk of malignancy, and that myositis-specific antibodies can be used to identify those at greatest risk.