caa a22 4500 445808144 CHVBK 20180317145203.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00415-011-5929-9 doi (NATIONALLICENCE)springer-10.1007/s00415-011-5929-9 Cancer and multiple sclerosis in the era of disease-modifying treatments [Elektronische Daten] [Christine Lebrun, Patrick Vermersch, David Brassat, Gilles Defer, Lucien Rumbach, Pierre Clavelou, Marc Debouverie, Jérôme de Seze, Sandrine Wiertlevsky, Olivier Heinzlef, Ayman Tourbah, Agnes Fromont, Marc Frenay] Prior to the era of disease-modifying therapies (DMT), multiple sclerosis (MS) was linked to reduced rates of cancer. Early use of immunosuppressors (IS) in MS justifies the follow-up of patients to evaluate a possible increase in the incidence of cancer in these patients. We performed a descriptive study of MS patients with a documented oncological event. Among the 22,563 MS patients in the EDMUS databases, patients with a history of cancer were identified, and cancer risk in a multiple sclerosis cohort (CARIMS) was evaluated. Four groups were defined: (A) MS patients without cancer receiving DMT or not, (B) MS patients with cancer but without any history of DMT, (C) MS patients with cancer who received an immunomodulator (IM), and/or (D) MS patients treated with an IS. A total of 9,269 patients (44.1%) had a history of DMT (52% IM; 18% IS; 30% both); 253 patients with MS and cancer were identified, 182 had a history of DMT. The mean duration of DMT was longer for group D (A: 3.6years vs. D: 4.9years; P<0.01). There was no increased risk of cancer among patients treated exclusively with IM. IS treatment (P=0.043) and the duration of exposure (P<0.001) significantly increased the risk of cancer, especially skin cancer, as observed in other autoimmune diseases. This result could influence the attitude of the medical profession with respect to the benefit to risk ratio when proposing DMT to MS patients. Springer-Verlag, 2011 Cancer nationallicence Multiple sclerosis nationallicence Immunosuppressive drug therapies nationallicence Interferon beta nationallicence Lebrun Christine Service de Neurologie, CHU Pasteur, 30 voie romaine, 06002, Nice, France aut Vermersch Patrick Service de Neurologie, CHU Salengro, Lille, France aut Brassat David Service de Neurologie, CHU Purpan, Toulouse, France aut Defer Gilles Service de Neurologie, CHU Côte de Nacre, Caen, France aut Rumbach Lucien Service de Neurologie, CHU Minjoz, Besançon, France aut Clavelou Pierre Service de Neurologie, CHU Montpied, Clermont-Ferrand, France aut Debouverie Marc Service de Neurologie, CHU Central, Nancy, France aut de Seze Jérôme Service de Neurologie, CHU Central, Strasbourg, France aut Wiertlevsky Sandrine Service de Neurologie, CHU Nantes, Nantes, France aut Heinzlef Olivier Service de Neurologie, Hôpital de Poissy, Poissy, France aut Tourbah Ayman Service de Neurologie, CHU Reims, Reims, France aut Fromont Agnes Service de Neurologie, CHU Dijon, Dijon, France aut Frenay Marc Oncologie Médicale, Pharmacologie Clinique, Nice, France aut Journal of Neurology Springer-Verlag 258/7(2011-07-01), 1304-1311 0340-5354 258:7<1304 2011 258 415 https://doi.org/10.1007/s00415-011-5929-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-5929-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lebrun Christine Service de Neurologie, CHU Pasteur, 30 voie romaine, 06002, Nice, France aut NATIONALLICENCE 700 1- Vermersch Patrick Service de Neurologie, CHU Salengro, Lille, France aut NATIONALLICENCE 700 1- Brassat David Service de Neurologie, CHU Purpan, Toulouse, France aut NATIONALLICENCE 700 1- Defer Gilles Service de Neurologie, CHU Côte de Nacre, Caen, France aut NATIONALLICENCE 700 1- Rumbach Lucien Service de Neurologie, CHU Minjoz, Besançon, France aut NATIONALLICENCE 700 1- Clavelou Pierre Service de Neurologie, CHU Montpied, Clermont-Ferrand, France aut NATIONALLICENCE 700 1- Debouverie Marc Service de Neurologie, CHU Central, Nancy, France aut NATIONALLICENCE 700 1- de Seze Jérôme Service de Neurologie, CHU Central, Strasbourg, France aut NATIONALLICENCE 700 1- Wiertlevsky Sandrine Service de Neurologie, CHU Nantes, Nantes, France aut NATIONALLICENCE 700 1- Heinzlef Olivier Service de Neurologie, Hôpital de Poissy, Poissy, France aut NATIONALLICENCE 700 1- Tourbah Ayman Service de Neurologie, CHU Reims, Reims, France aut NATIONALLICENCE 700 1- Fromont Agnes Service de Neurologie, CHU Dijon, Dijon, France aut NATIONALLICENCE 700 1- Frenay Marc Oncologie Médicale, Pharmacologie Clinique, Nice, France aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/7(2011-07-01), 1304-1311 0340-5354 258:7<1304 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer