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The association between infection incidence and autoimmune diseases in breast cancer patients after anti-cancer treatment.

ABSTRACT: Purpose: To evaluate the infection incidence in breast cancer patients whether they have a major autoimmune disease or not. Methods: This retrospective cohort study compared the infection incidence of 174 breast cancer patients with an autoimmune disease, including Sjogren's Syndrome (SS), Rheumatoid Arthritis (RA), and Systemic Lupus Erythematosus (SLE), along with 4429 patients without an autoimmune disease, for the period 2000 to 2016. Six-hundred and ninety six, age-, stage-, and diagnosis era-matched patients without any autoimmune disease were analyzed to eliminate the effects of these confounding factors may have on the results. Results: After adjusting for age, stage and diagnosis era, breast cancer patients with an autoimmune disease had a higher Infection Incidence Ratio (IRR: 2.62) than the patients without any autoimmune disease. In the univariate analysis, patients who had an autoimmune disease (p<0.001), underwent chemotherapy (p<0.001), radiotherapy (p=0.004), and monoclonal antibody therapy (p<0.001) had a higher infection rate. In the multivariate analysis, autoimmune disease was shown to be an independent factor for infection incidence. Conclusion: Autoimmune disease was a potential predictor of infection incidence in breast cancer patients post-treatment after adjusting for clinical confounding factors.

SUBMITTER: Chen CC

PROVIDER: S-EPMC6400812 | biostudies-other | 2019

REPOSITORIES: biostudies-other

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The association between infection incidence and autoimmune diseases in breast cancer patients after anti-cancer treatment.

Chen Chien-Chih CC Ho Wei-Li WL Chen Hsin-Hua HH Sheu Meei-Ling ML Hsu Chiann-Yi CY Chen Jun-Peng JP

Journal of Cancer 20190129 4

<b>Purpose</b>: To evaluate the infection incidence in breast cancer patients whether they have a major autoimmune disease or not. <b>Methods</b>: This retrospective cohort study compared the infection incidence of 174 breast cancer patients with an autoimmune disease, including Sjogren's Syndrome (SS), Rheumatoid Arthritis (RA), and Systemic Lupus Erythematosus (SLE), along with 4429 patients without an autoimmune disease, for the period 2000 to 2016. Six-hundred and ninety six, age-, stage-, a ...[more]

PMID: 30854088

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Project description:Importance:The association between exposure to hormone-modulating therapy (HMT) as breast cancer treatment and neurodegenerative disease (NDD) is unclear. Objective:To determine whether HMT exposure is associated with the risk of NDD in women with breast cancer. Design, Setting, and Participants:This retrospective cohort study used the Humana claims data set from January 1, 2007, to March 31, 2017. The Humana data set contains claims from private-payer and Medicare insurance data sets from across the United States with a population primarily residing in the Southeast. Patient claims records were surveyed for a diagnosis of NDD starting 1 year after breast cancer diagnosis for the duration of enrollment in the claims database. Participants were 57?843 women aged 45 years or older with a diagnosis of breast cancer. Patients were required to be actively enrolled in Humana claims records for 6 months prior to and at least 3 years after the diagnosis of breast cancer. The analyses were conducted between January 1 and 15, 2020. Exposure:Hormone-modulating therapy (selective estrogen receptor modulators, estrogen receptor antagonists, and aromatase inhibitors). Main Outcomes and Measures:Patients receiving HMT for breast cancer treatment were identified. Survival analysis was used to determine the association between HMT exposure and diagnosis of NDD. A propensity score approach was used to minimize measured and unmeasured selection bias. Results:Of the 326?485 women with breast cancer in the Humana data set between 2007 and 2017, 57?843 met the study criteria. Of these, 18?126 (31.3%; mean [SD] age, 76.2 [7.0] years) received HMT, whereas 39?717 (68.7%; mean [SD] age, 76.8 [7.0] years) did not receive HMT. Mean (SD) follow-up was 5.5 (1.8) years. In the propensity score-matched population, exposure to HMT was associated with a decrease in the number of women who received a diagnosis of NDD (2229 of 17 878 [12.5%] vs 2559 of 17 878 [14.3%]; relative risk, 0.89; 95% CI, 0.84-0.93; P?<?.001), Alzheimer disease (877 of 17 878 [4.9%] vs 1068 of 17 878 [6.0%]; relative risk, 0.82; 95% CI, 0.75-0.90; P?<?.001), and dementia (1862 of 17 878 [10.4%] vs 2116 of 17 878 [11.8%]; relative risk, 0.88; 95% CI, 0.83-0.93; P?<?.001). The number needed to treat was 62.51 for all NDDs, 93.61 for Alzheimer disease, and 69.56 for dementia. Conclusions and Relevance:Among patients with breast cancer, tamoxifen and steroidal aromatase inhibitors were associated with a decrease in the number who received a diagnosis of NDD, specifically Alzheimer disease and dementia.

Dataset Information

The association between infection incidence and autoimmune diseases in breast cancer patients after anti-cancer treatment.

Publications

The association between infection incidence and autoimmune diseases in breast cancer patients after anti-cancer treatment.

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