Contributions
Abstract: EP1445
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Comorbidity
Introduction: The relationship between multiple sclerosis (MS) and cancer, has long been investigated but results have been not conclusive yet and a higher risk has been associated only with the previous use of immunosuppressants. The estimated prevalence rate (EPR) of cancer in MS patients is 4.39% and there is no estimated data in those over 50. Since the arrival of new and more effective immunomodulatory treatments and its use in increasingly older patients, a possible higher prevalence of cancer is expected. The aim of this study is to clarify the prevalence of cancer in older MS patients and to evaluate the effect of exposure to disease modifying-treatments (DMTs)
Material and methods: We assessed the prevalence of cancer in a cohort of 155 MS patients older than 50 years. Demographic and clinical data were collected retrospectively from the database of Puerta de Hierro University Hospital. Clinical and radiological isolated syndromes were excluded. We carried out a descriptive and multivariate analysis using a logistic regression model to assess the relationships between the use of DMTs adjusted to exposure time and the prevalence of cancer
Results: No differences in gender, clinical activity or type of MS were found in patients with cancer compared to the whole sample. A total of 11 neoplasms were detected in 10 patients (7.1%), a little higher than expected predominantly in >65 years (EPR: 98 for 50-55 years, 128 for 55-64 years and 138 for >65 years). A complete remission was observed in 8 of them. Only one death ascribed to cancer was reported. The more frequent cancer was non-melanoma skin cancer and melanoma (18.2% for each). The percentage of melanoma in this study was 4 times higher than expected. The mean number of previous DMTs was greater in patients with cancer (2.3+/-0.8 vs 1.5+/-1.2) and a positive correlation was found between cancer occurrence and the number of previous DMTs (OR=1.4 95%IC:2.2-0.6 p=0.001) without a direct relationship with any specific DMT. As expected age was positively correlated to cancer occurrence (OR=0.07 95%IC:1.4-0.03 p=0.04) and negatively to disease remission (OR=-0.1 95%IC:0.3-0.01 p=0.03)
Conclusions: Our findings indicate that in patients older than 50 years, the prevalence of cancer is higher than expected and the use of a higher number of DMTs seems to be a risk factor. Further study is needed to assess possible associations between long-term exposure to the novel DMTs in MS and rate of cancer
Disclosure: - Antonio García-Merino: has received honoraria for lecturing, consulting or travel expenses from Bayer, Biogen-Idec, Merck, Teva, Novartis, Roche, Almirall and Genzyme, and research grants from Merck and Novartis.
-Irene Moreno Torres: has received honoraria for lecturing, education and travel expenses from Merck, Roche, Teva, Novartis, Biogen and Genzyme.
-Julia Sabin Muñoz has received honoraria for lecturing and travel expenses from Merck, Teva, Novartis, Biogen and Genzyme
-Andrea Castro-Villacañas Farzamnia has received education and travel expenses from Biogen, Esteve, Novartis, Qualigen, Genzyme and Zambon
-Elisa Gamo Gonzalez has received education and travel expenses from Chiesi
-Erika María Beck Román has received education and travel expenses from Biogen, Teva, Novartis and Genzyme
- Sabela Novo Ponte has received education and travel expenses from Qualigen, Teva, Novartis, Zambon, Bayer and UCB.
- Lorena Fernández Gil has received education and travel expenses from Teva, Novartis and Genzyme
- Luis Mena Romo: nothing to disclose
- María Rosario Blasco Quiléz: nothing to disclose
-Santiago David Valenzuela Chamorro: nothing to disclose
Abstract: EP1445
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Comorbidity
Introduction: The relationship between multiple sclerosis (MS) and cancer, has long been investigated but results have been not conclusive yet and a higher risk has been associated only with the previous use of immunosuppressants. The estimated prevalence rate (EPR) of cancer in MS patients is 4.39% and there is no estimated data in those over 50. Since the arrival of new and more effective immunomodulatory treatments and its use in increasingly older patients, a possible higher prevalence of cancer is expected. The aim of this study is to clarify the prevalence of cancer in older MS patients and to evaluate the effect of exposure to disease modifying-treatments (DMTs)
Material and methods: We assessed the prevalence of cancer in a cohort of 155 MS patients older than 50 years. Demographic and clinical data were collected retrospectively from the database of Puerta de Hierro University Hospital. Clinical and radiological isolated syndromes were excluded. We carried out a descriptive and multivariate analysis using a logistic regression model to assess the relationships between the use of DMTs adjusted to exposure time and the prevalence of cancer
Results: No differences in gender, clinical activity or type of MS were found in patients with cancer compared to the whole sample. A total of 11 neoplasms were detected in 10 patients (7.1%), a little higher than expected predominantly in >65 years (EPR: 98 for 50-55 years, 128 for 55-64 years and 138 for >65 years). A complete remission was observed in 8 of them. Only one death ascribed to cancer was reported. The more frequent cancer was non-melanoma skin cancer and melanoma (18.2% for each). The percentage of melanoma in this study was 4 times higher than expected. The mean number of previous DMTs was greater in patients with cancer (2.3+/-0.8 vs 1.5+/-1.2) and a positive correlation was found between cancer occurrence and the number of previous DMTs (OR=1.4 95%IC:2.2-0.6 p=0.001) without a direct relationship with any specific DMT. As expected age was positively correlated to cancer occurrence (OR=0.07 95%IC:1.4-0.03 p=0.04) and negatively to disease remission (OR=-0.1 95%IC:0.3-0.01 p=0.03)
Conclusions: Our findings indicate that in patients older than 50 years, the prevalence of cancer is higher than expected and the use of a higher number of DMTs seems to be a risk factor. Further study is needed to assess possible associations between long-term exposure to the novel DMTs in MS and rate of cancer
Disclosure: - Antonio García-Merino: has received honoraria for lecturing, consulting or travel expenses from Bayer, Biogen-Idec, Merck, Teva, Novartis, Roche, Almirall and Genzyme, and research grants from Merck and Novartis.
-Irene Moreno Torres: has received honoraria for lecturing, education and travel expenses from Merck, Roche, Teva, Novartis, Biogen and Genzyme.
-Julia Sabin Muñoz has received honoraria for lecturing and travel expenses from Merck, Teva, Novartis, Biogen and Genzyme
-Andrea Castro-Villacañas Farzamnia has received education and travel expenses from Biogen, Esteve, Novartis, Qualigen, Genzyme and Zambon
-Elisa Gamo Gonzalez has received education and travel expenses from Chiesi
-Erika María Beck Román has received education and travel expenses from Biogen, Teva, Novartis and Genzyme
- Sabela Novo Ponte has received education and travel expenses from Qualigen, Teva, Novartis, Zambon, Bayer and UCB.
- Lorena Fernández Gil has received education and travel expenses from Teva, Novartis and Genzyme
- Luis Mena Romo: nothing to disclose
- María Rosario Blasco Quiléz: nothing to disclose
-Santiago David Valenzuela Chamorro: nothing to disclose