Pruritus and Its Association With Cancer and Mortality in Dermatomyositis and Polymyositis: A Nationwide Cohort Study in Taiwan From 2005 to 2022

IF 3.7 4区医学 Q1 DERMATOLOGY

Dermatologic Therapy Pub Date : 2025-06-09 DOI:10.1155/dth/9963667

Der-Jr Huang, Yu-Hsuan Joni Shao, Yi-Hsien Shih, Woan-Ruoh Lee, Ling-Ya Huang, Yu-Min Kuo, Quoc Thao Trang Pham, Hao-Jui Weng

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引用次数: 0

Abstract

Background: Pruritus is the most common initial symptom reported by patients with dermatomyositis (DM) and polymyositis (PM). However, there is limited data regarding the impact of pruritus on cancer and mortality in patients with DM and PM. In this study, we aimed to investigate how pruritus is associated with cancer and mortality in patients with DM and PM.

Methods: This nationwide, population-based retrospective cohort study included adult DM and PM patients from Taiwan’s National Health Insurance Research Database between 2005 and 2022. Sex- and age-matched pruritic patients, identified by over 6 weeks of antipruritic medication use, and nonpruritic patients were analyzed. The primary outcome was cancer occurrence or all-cause mortality. The association between pruritus and these outcomes was estimated using Cox proportional hazards models.

Results: Among 919 matched pairs of pruritic and nonpruritic patients, cancer was observed in 19.96% in the long-term pruritic group (LPG), 14.63% in the short-term pruritic group (SPG), and 10.34% in the non-pruritic group (NPG) (p < 0.0001). All-cause mortality was documented as 30.37% in the LPG, 29.69% in the SPG, and 37.76% in the NPG (p < 0.0001). After adjusting for sex, age, and other comorbidities, pruritus was associated with an increased risk of cancer (hazard ratio (HR) 1.708, 95% confidence interval (CI) 1.229–2.374) and a lower risk of all-cause mortality (HR 0.483, 95% CI 0.409–0.569).

Conclusion: This population-based study revealed that pruritus appeared to be associated with increased risks of cancer and decreased all-cause mortality. Thus, pruritus may serve as a pragmatic factor for risk stratification and tailored treatment strategies in DM and PM. Cancer screening, particularly for nasopharyngeal and breast cancers in East Asian populations, is recommended for patients with DM or PM, especially those presenting with pruritus. Meanwhile, patients without pruritus may require vigilant management for potentially life-threatening complications and comorbidities.

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皮肤肌炎及多发性肌炎患者瘙痒及其与癌症及死亡率的关系：台湾2005年至2022年的全国性队列研究

背景：瘙痒是皮肌炎（DM）和多发性肌炎（PM）患者最常见的首发症状。然而，关于瘙痒对糖尿病和PM患者的癌症和死亡率的影响的数据有限。在这项研究中，我们旨在探讨瘙痒与糖尿病和PM患者的癌症和死亡率之间的关系。方法：这项全国性的、以人群为基础的回顾性队列研究纳入了2005年至2022年间来自台湾全民健康保险研究数据库的成年糖尿病和PM患者。分析了性别和年龄匹配的瘙痒患者，通过使用6周以上的止痒药物来确定，以及非瘙痒患者。主要结局是癌症发生率或全因死亡率。使用Cox比例风险模型估计瘙痒与这些结果之间的关系。结果：在919对瘙痒性和非瘙痒性患者中，长期瘙痒组（LPG）的癌症发生率为19.96%，短期瘙痒组（SPG）的癌症发生率为14.63%，非瘙痒性组（NPG）的癌症发生率为10.34% (p <；0.0001)。LPG组的全因死亡率为30.37%，SPG组为29.69%，NPG组为37.76% (p <；0.0001)。在对性别、年龄和其他合共病进行校正后，瘙痒与癌症风险增加（风险比（HR） 1.708, 95%可信区间（CI） 1.229-2.374）和全因死亡风险降低（HR 0.483, 95% CI 0.409-0.569）相关。结论：这项基于人群的研究显示，瘙痒似乎与癌症风险增加和全因死亡率降低有关。因此，瘙痒可以作为DM和PM的风险分层和定制治疗策略的实用因素。对于糖尿病或PM患者，特别是伴有瘙痒的患者，建议进行癌症筛查，特别是东亚人群的鼻咽癌和乳腺癌筛查。同时，没有瘙痒的患者可能需要警惕潜在的危及生命的并发症和合并症的管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatologic Therapy 医学-皮肤病学

CiteScore

7.00

自引率

8.30%

发文量

711

审稿时长

3 months

期刊介绍： Dermatologic Therapy has been created to fill an important void in the dermatologic literature: the lack of a readily available source of up-to-date information on the treatment of specific cutaneous diseases and the practical application of specific treatment modalities. Each issue of the journal consists of a series of scholarly review articles written by leaders in dermatology in which they describe, in very specific terms, how they treat particular cutaneous diseases and how they use specific therapeutic agents. The information contained in each issue is so practical and detailed that the reader should be able to directly apply various treatment approaches to daily clinical situations. Because of the specific and practical nature of this publication, Dermatologic Therapy not only serves as a readily available resource for the day-to-day treatment of patients, but also as an evolving therapeutic textbook for the treatment of dermatologic diseases.