Malignancy in Psoriatic Disease - ACR Meeting Abstracts

Anastasiya Muntyanu¹, Ker-Ai Lee², Justine Y. Ye³, Ari Polachek³, Vinod Chandran⁴, Richard J. Cook² and Dafna D Gladman¹, ¹University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, ²Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada, ³Rheumatology, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, ⁴Medicine, Krembil Research Institute, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: malignancy and psoriatic arthritis

Session Information

Date: Monday, October 22, 2018

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Clinical/Epidemiology Studies

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

There are conflicting data between studies of psoriasis and psoriatic arthritis (PsA), and there have been recent concerns about the potential of anti-TNF agents to facilitate malignancy. We aimed to estimate the prevalence and incidence of malignancy and its types in PsA and psoriasis without arthritis (PsC) patients, in comparison to the general population, and to identify the predictive factors for developing cancer in psoriatic disease (PsD).

Methods:

Patients with PsA have attended the PsA Clinic and have been followed prospectively since 1978. Patients with PsC have been assessed by a rheumatologist to confirm the absence of PsA and have been followed since 2006. Patients have been evaluated at 6-12 month intervals according to a standard protocol which includes demographics, lifestyle habits, medical history, co-morbidities, and disease-related outcomes. Malignancies are recorded prospectively. In addition, a linkage with Cancer Care Ontario and the Death Registry was carried out to confirm the identification of malignancy and the type of malignancy to the end of December 2016. Non- melanoma skin cancers were not included. Descriptive statistics are provided. Standardized incidence ratios (SIR) were calculated for overall cancers and by sex. Multistate analysis was performed.

Results:

2124 patients (PsA and PsC) were included in the study of whom, 235 developed cancer (11%). 168 patients developed cancer after first clinic visit and are included in this report. Overall malignancy SIR is 0.89 (0.74, 1.07), SIR for females is 1.13 (0.87, 1.45), and for males 0.72 (0.55, 0.94). The most common malignancies were skin, breast, and male reproductive system. No predictor for malignancy was identified for PsD overall nor for PsA or PsC individually.

Conclusion:

In this long-term prospective follow up of patients with PsA and PsC the malignancy risk is not increased. No predictors for malignancy could be identified. In particular there was no increased risk associated with biologics use.

Table1. Demographic and disease features by groups

PsA

PsC

demographics

malignancy group

no malignancy group

malignancy group

no malignancy group

(N=148)

(N=1267)

(N=20)

(N=622)

Age**

50.8

(11.7)

43.2

(12.9)

(9.9)

45.5

(13.5)

AGE_PS**

33.3

(15.5)

27.6

(14.2)

41.9

(17.5)

29.8

(15.7)

AGE_PSA**

42.9

(13)

37.1

(13.4)

Smoker*

(42%)

491

(39%)

(80%)

308

(50%)

Alcohol use*

(56%)

560

(60%)

(70%)

424

(69%)

Married*

(43%)

605

(48%)

(40%)

338

(54%)

Employed*

(37%)

670

(53%)

(70%)

474

(76%)

Education ³ college*

(41%)

671

(53%)

(85%)

480

(77%)

Deceased*

(39%)

132

(10%)

(20%)

(1%)

Gender*

. FEMALE

(49%)

546

(43%)

(55%)

262

(42%)

. MALE

(51%)

721

(57%)

(45%)

356

(58%)

Disease features

BSA**

(6.9)

2.1

(8.1)

4.6

(6.5)

5.2

(10.1)

PASI**

3.1

(6.3)

3.9

(7.0)

4.9

(4.5)

5.7

(6.1)

DAMGTOT**

3.5

(8.1)

2.4

(6.4)

0.3

(0.9)

(0.4)

AJTOT**

9.8

(9.0)

9.4

(10.1)

0.2

(0.7)

0.1

(0.7)

Depression*

(3%)

(7%)

(20%)

(8%)

Obesity*

(36%)

177

(35%)

(32%)

160

(28%)

Cardio Vascular Disease*

(3%)

(2%)

(10%)

(2%)

Diabetes*

(9%)

(6%)

(15%)

(7%)

Dactylitis*

(33%)

343

(27%)

(0%)

Enthesitis*

(11%)

225

(18%)

(5%)

(1%)

Inflammatory Back pain*

(7%)

219

(17%)

(10%)

(2%)

Axial*

(23%)

241

(22%)

(33%)

(0%)

* number of cases (%)

** mean (st.d)

Disclosure: A. Muntyanu, None; K. A. Lee, None; J. Y. Ye, None; A. Polachek, None; V. Chandran, None; R. J. Cook, None; D. D. Gladman, Janssen Research and Development, LLC, 2.

To cite this abstract in AMA style:

Muntyanu A, Lee KA, Ye JY, Polachek A, Chandran V, Cook RJ, Gladman DD. Malignancy in Psoriatic Disease [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/malignancy-in-psoriatic-disease/. Accessed .

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