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ACR Special Report: Philadelphia, PA, October 18-21, 2009

Introduction
Highlights of the American College of Rheumatology 2010 Annual Scientific Meeting
The Latest Treatment Advances for Lupus
Treatment May Prevent Neonatal Lupus
The Brain and Lupus: 2010 Update
Risk of Some Cancers Double in Lupus
Assessing the Cost of Lupus
From the Lab to the Clinic: Lessons Learned About Lupus
ALR-Supported Research Focus of Plenary Session

Risk of Some Cancers Double in Lupus

Previous research has shown a link between lupus and certain cancers, particularly lymphoma. To determine whether there is actually an increased risk of cancer in patients with lupus, Sasha R. Bernatsky, MD, PhD, of McGill University in Montreal, and her colleagues analyzed data from more than 13,000 people from 24 lupus centers around the world followed for an average of 9 years. They found an overall 15% increased risk of cancer, but a more than doubled risk of blood-related cancers such as lymphoma, non-Hodgkin’s lymphoma, and leukemia.xiv

There was also an increased risk for lung, cervical, vulval and vaginal cancer, the latter three possibly related to an inability of patients to clear the human papillomavirus (HPV) responsible for most such cancers. The good news was that the risk of breast, endometrial, and ovarian cancers were lower in women with lupus, she said, possibly related to some alteration in the metabolism of estrogen or even genetic differences.

Although the risk of blood-related cancers is higher in patients with lupus, their overall incidence is still incredibly rare. “So if you followed 2,000 lupus patients for a year, you might see one additional cancer,” she said. “It’s important to know about (the increased risk) and to study it to understand more about the pathogenesis, but we don’t want to scare any lupus patients,” she said. The higher incidence may also be related to the treatments women with lupus undergo, which Dr. Bernatsky’s group is also investigating.

Key point: The higher incidence in lung cancer and cancers related to HPV makes it all the more important that women with lupus quit smoking and get regular Pap smears and vaginal examinations, which can find early evidence of HPV-related cancers.


More information about lupus and treatment advances can be found by visiting www.lupusresearch.org.

The 2010 American College of Rheumatology Meeting Special Report was made possible in part by generous support from Biogen Idec, Genentech and Johnson & Johnson.

©2010 Alliance for Lupus Research. All Rights Reserved.

Contents herein may not be reproduced, republished or distributed without the prior written permission of the Alliance for Lupus Research. To request permission to reproduce, republish or distribute any part of this report, contact us at 212-218-2840 or email info@lupusresearch.org.


i Bingham CO, et al. Citrullination and Peptidylarginine Deiminase (PAD) Expression Is Detected in the Oral Mucosa and Periodontium in the Absence of Rheumatoid Arthritis.
ii Scher JU, et al. Characteristic Oral and Intestinal Microbiota in Rheumatoid Arthritis (RA): A Trigger for Autoimmunity?
iii Merrill JT, et al. Five-Year Experience with Belimumab, a BLyS-Specific Inhibitor, in Patients with Systemic Lupus Erythematosus (SLE).
iv Vollenhoven RF, et al. Belimumab, a BLyS-Specific Inhibitor, Reduced Corticosteroid Use in Patients with Active SLE: Results from the Phase 3 BLISS-52 and -76 Studies.
v Petri MA, et al. Belimumab, a BLyS-Specific Inhibitor, Reduced Disease Activity, Flares, and Prednisone Use in Patients with Seropositive SLE: Combined Efficacy Results from the Phase 3 BLISS-52 and -76 Studies.
vi Chatham WW. Effect of Belimumab, a B-Lymphocyte Stimulator–Specific Inhibitor, on Functional Antibodies to Pneumococcal, Tetanus, and Influenza Vaccines.
vii Stohl W. Belimumab, a BLyS-Specific Inhibitor, Significantly Reduced Autoantibodies, Normalized Low Complement, and Reduced Selected B-Cell Populations in Patients with Seropositive Systemic Lupus Erythematosus (SLE): The Phase 3 BLISS Studies.
viii Wallace DJ, et al. Epratuzumab Demonstrates Clinically Meaningful Improvements in Patients with Moderate to Severe Systemic Lupus Erythematosus (SLE): Results from EMBLEM™, a Phase IIb Study.
ix Kalunian KC, et al. BILAG-Measured Improvement in Moderately and Severely Affected Body Systems in Patients with Systemic Lupus Erythematosus (SLE) by Epratuzumab: Results from EMBLEM™, a Phase IIb Study.
x Sullivan BA, et al. A Flow Cytometric Receptor Occupancy Assay Demonstrates Dose-Dependent Blockade of B7RP-1 by AMG 557 on Circulating B Cells from SLE Subjects.
xi Fleischmann RM. Evidence of Peripheral B Cell Depletion in Subjects with Controlled Systemic Lupus Erythematosus (SLE) Following Subcutaneous Administration of SBI-087.
xii Salwsky KA, et al. A Systematic Literature Review of the Direct Costs of Systemic Lupus Erythematosus (SLE) in the United States (US).
xiii McBurney CA. Platelet C4d Is Associated with All-Cause Mortality in Patients with Systemic Lupus Erythematosus.
xiv Bernatsky SR, et al. Further Defining Cancer Risk in Systemic Lupus: Updated Results in an Expanded International Multi-Centre Cohort
xv Hanly JG, Urowitz MB, Sanchez-Guerrero J, et al. Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: an international inception cohort study. Arthritis Rheum. 2007;56(1):265-73.
xvi Izmirly PM, et al. Hydroxychloroquine and Prevention of Anti-SSA/Ro Associated Cardiac Disease in Mothers with a Previous Child with Neonatal Lupus
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