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Research article
Shengyun Liu
Zhengzhou University First Affiliated Hospital
Corresponding Author
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Background Systemic lupus erythematosus (SLE) is associated with increased risk of cancer and the mechanism remains unclear. Here, we examined the level of auto-antibodies and disease activity index scores in SLE patients with cancers, and analyzed whether medications for SLE management might contribute higher cancer risk in SLE patients.
Methods In this retrospective study, we carried out a nested case-control study in a large cohort of SLE patients. We screened 5858 SLE patients to identify the newly diagnosed and yet to be treated cancers. The following clinical features were evaluated: auto-antibodies levels, SLE disease activity index scores and previous medication used for SLE management. Systemic glucocorticoid, cyclophosphamide, hydroxychloroquine (HCQ), methotrexate and azathioprine were considered the main medication indices.
Results Our analyses identified 51 SLE patients who also had cancer, and 204 matched control patients who had SLE but not cancer. Of the 51 SLE patients, thyroid cancer (14/51, 27.45%), cervical cancer (10/51, 19.61%) and lung cancer (7/51, 13.73%) were the most common types. Our analyses did not reveal any significant differences in the levels of auto-antibodies in SLE patients with cancers relative to the control group. Further, we observed that disease activity was significantly lower in SLE patients with cancers relative to the matched control SLE group. There was no statistically significant association between the cancer risk and the use of systemic glucocorticoid, cyclophosphamide, methotrexate or azathioprine. Importantly, the administration of HCQ was significantly lower in SLE patients suffering cancers relative to the cancer free matched control group.
Conclusions Our analyses indicate that SLE patients with cancers might have a lower disease activity at the time of cancer diagnosis. HCQ was negatively correlated with cancer risk in SLE patients. These findings highlight a potential and novel prevention strategy for SLE.
Keywords
Lupus, Cancer, Autoantibody, Disease activity, Hydroxycholoquine
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at Arthritis Research & Therapy.
No community comments so far
Editorial decision: Accept
On 29 May, 2020
Review #2 received
Received 28 May, 2020
Reviewer #2 agreed
On 26 May, 2020
Reviewer #1 agreed
On 24 May, 2020
Review #1 received
Received 24 May, 2020
Reviewers invited
Invitations sent on 21 May, 2020
Editor assigned
On 06 May, 2020
Submission checks complete
On 05 May, 2020
Editor invited
On 05 May, 2020
Version 1
Posted 21 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 14 Apr, 2020
Review #2 received
Received 09 Apr, 2020
Review #1 received
Received 07 Apr, 2020
Reviewer #1 agreed
On 27 Mar, 2020
Reviewer #2 agreed
On 27 Mar, 2020
Reviewers invited
Invitations sent on 25 Mar, 2020
Editor assigned
On 21 Jan, 2020
Editor invited
On 20 Jan, 2020
Submission checks complete
On 17 Jan, 2020
First submitted
On 16 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Rheumatology
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A new preprint design is coming!
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See the published version of this preprint at Arthritis Research & Therapy.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Shengyun Liu
Zhengzhou University First Affiliated Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Arthritis Research & Therapy.
No community comments so far
Editorial decision: Accept
On 29 May, 2020
Review #2 received
Received 28 May, 2020
Reviewer #2 agreed
On 26 May, 2020
Reviewer #1 agreed
On 24 May, 2020
Review #1 received
Received 24 May, 2020
Reviewers invited
Invitations sent on 21 May, 2020
Editor assigned
On 06 May, 2020
Submission checks complete
On 05 May, 2020
Editor invited
On 05 May, 2020
Version 1
Posted 21 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 14 Apr, 2020
Review #2 received
Received 09 Apr, 2020
Review #1 received
Received 07 Apr, 2020
Reviewer #1 agreed
On 27 Mar, 2020
Reviewer #2 agreed
On 27 Mar, 2020
Reviewers invited
Invitations sent on 25 Mar, 2020
Editor assigned
On 21 Jan, 2020
Editor invited
On 20 Jan, 2020
Submission checks complete
On 17 Jan, 2020
First submitted
On 16 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Rheumatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Arthritis Research & Therapy.
Background Systemic lupus erythematosus (SLE) is associated with increased risk of cancer and the mechanism remains unclear. Here, we examined the level of auto-antibodies and disease activity index scores in SLE patients with cancers, and analyzed whether medications for SLE management might contribute higher cancer risk in SLE patients.
Methods In this retrospective study, we carried out a nested case-control study in a large cohort of SLE patients. We screened 5858 SLE patients to identify the newly diagnosed and yet to be treated cancers. The following clinical features were evaluated: auto-antibodies levels, SLE disease activity index scores and previous medication used for SLE management. Systemic glucocorticoid, cyclophosphamide, hydroxychloroquine (HCQ), methotrexate and azathioprine were considered the main medication indices.
Results Our analyses identified 51 SLE patients who also had cancer, and 204 matched control patients who had SLE but not cancer. Of the 51 SLE patients, thyroid cancer (14/51, 27.45%), cervical cancer (10/51, 19.61%) and lung cancer (7/51, 13.73%) were the most common types. Our analyses did not reveal any significant differences in the levels of auto-antibodies in SLE patients with cancers relative to the control group. Further, we observed that disease activity was significantly lower in SLE patients with cancers relative to the matched control SLE group. There was no statistically significant association between the cancer risk and the use of systemic glucocorticoid, cyclophosphamide, methotrexate or azathioprine. Importantly, the administration of HCQ was significantly lower in SLE patients suffering cancers relative to the cancer free matched control group.
Conclusions Our analyses indicate that SLE patients with cancers might have a lower disease activity at the time of cancer diagnosis. HCQ was negatively correlated with cancer risk in SLE patients. These findings highlight a potential and novel prevention strategy for SLE.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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