Risk of extrathymic cancer in patients with myasthenia gravis in Taiwan

A nationwide population-based study

C. J. Liu, Y. S. Chang, C. J. Teng, T. J. Chen, S. M. Ou, C. H. Tzeng, S. J. Wang

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background and purpose: The relationship between myasthenia gravis (MG) and extrathymic malignancies has not been determined. This study aimed to explore the risk of extrathymic malignancy in patients with MG based on a nationwide population-based dataset. Methods: We identified 2614 patients with MG from the Taiwan National Health Insurance database between 1997 and 2005 and compared the incidence rates of extrathymic malignancies with 15684 randomly selected age-, sex-, and comorbidity-matched subjects without MG. Both cohorts were followed until the end of 2009. Cox proportional hazard model was used to evaluate the predictors of extrathymic malignancy in the MG cohort, including age, sex, comorbidities, and prescription drugs. Results: After an average follow-up of 8years, the MG cohort had a higher risk of extrathymic cancers with an incidence rate ratio (IRR) of 1.38 (95% CI 1.12-1.68, P=0.002) than the control cohort. Although breast cancer was the most common cancer found, no statistically significant relationship between MG and any specific malignancy was observed. Cox multivariate proportional hazards analysis showed that only age (HR=1.05, 95% CI 1.04-1.06, P<0.001) and liver cirrhosis (IRR=3.85, 95% CI 1.22-12.14, P=0.021) were predictors of extrathymic cancers in the MG cohort. Conclusions: Our study showed that patients with MG had an increased risk of extrathymic malignancy in a follow-up of 8years, but no specific susceptibility to certain malignancies was found. © 2012 The Author(s). European Journal of Neurology © 2012 EFNS.

Original languageEnglish
Pages (from-to)746-751
Number of pages6
JournalEuropean Journal of Neurology
Volume19
Issue number5
DOIs
Publication statusPublished - May 2012
Externally publishedYes

Fingerprint

Myasthenia Gravis
Taiwan
Population
Neoplasms
Comorbidity
Incidence
Prescription Drugs
National Health Programs
Neurology
Proportional Hazards Models
Liver Cirrhosis
Databases
Breast Neoplasms

Keywords

  • Autoimmune disease
  • Cancer risk
  • Extrathymic malignancy
  • Immunosuppressant
  • Myasthenia gravis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Risk of extrathymic cancer in patients with myasthenia gravis in Taiwan : A nationwide population-based study. / Liu, C. J.; Chang, Y. S.; Teng, C. J.; Chen, T. J.; Ou, S. M.; Tzeng, C. H.; Wang, S. J.

In: European Journal of Neurology, Vol. 19, No. 5, 05.2012, p. 746-751.

Research output: Contribution to journalArticle

Liu, C. J. ; Chang, Y. S. ; Teng, C. J. ; Chen, T. J. ; Ou, S. M. ; Tzeng, C. H. ; Wang, S. J. / Risk of extrathymic cancer in patients with myasthenia gravis in Taiwan : A nationwide population-based study. In: European Journal of Neurology. 2012 ; Vol. 19, No. 5. pp. 746-751.
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AB - Background and purpose: The relationship between myasthenia gravis (MG) and extrathymic malignancies has not been determined. This study aimed to explore the risk of extrathymic malignancy in patients with MG based on a nationwide population-based dataset. Methods: We identified 2614 patients with MG from the Taiwan National Health Insurance database between 1997 and 2005 and compared the incidence rates of extrathymic malignancies with 15684 randomly selected age-, sex-, and comorbidity-matched subjects without MG. Both cohorts were followed until the end of 2009. Cox proportional hazard model was used to evaluate the predictors of extrathymic malignancy in the MG cohort, including age, sex, comorbidities, and prescription drugs. Results: After an average follow-up of 8years, the MG cohort had a higher risk of extrathymic cancers with an incidence rate ratio (IRR) of 1.38 (95% CI 1.12-1.68, P=0.002) than the control cohort. Although breast cancer was the most common cancer found, no statistically significant relationship between MG and any specific malignancy was observed. Cox multivariate proportional hazards analysis showed that only age (HR=1.05, 95% CI 1.04-1.06, P<0.001) and liver cirrhosis (IRR=3.85, 95% CI 1.22-12.14, P=0.021) were predictors of extrathymic cancers in the MG cohort. Conclusions: Our study showed that patients with MG had an increased risk of extrathymic malignancy in a follow-up of 8years, but no specific susceptibility to certain malignancies was found. © 2012 The Author(s). European Journal of Neurology © 2012 EFNS.

KW - Autoimmune disease

KW - Cancer risk

KW - Extrathymic malignancy

KW - Immunosuppressant

KW - Myasthenia gravis

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