Vitiligo may protect against internal malignancy
medwireNews: Patients with the autoimmune disorder vitiligo have a “markedly reduced” risk for developing malignancies of internal organs compared with other individuals, Korean researchers report.
“These findings suggest that autoimmune diseases, including vitiligo, may provide immune surveillance for the development of cancer beyond the targeted organ,” propose Miri Kim, from The Catholic University of Korea in Seoul, and co-workers.
The team used entries from the Korean National Health Insurance claims database from January 2007 until December 2016 to identify 101,078 patients with vitiligo and 202,156 patients without the skin disorder.
The incidence rate of internal malignancy was 612.9 cases per 100,000 person–years for the vitiligo cohort versus 708.9 cases per 100,000 person–years for controls. After adjusting for age, sex and comorbidity, patients with vitiligo had a significantly reduced risk for developing any internal malignancy compared with controls, with a hazard ratio (HR) of 0.86.
This included “remarkably” reduced risks for colorectal cancer (HR=0.62), ovarian cancer (HR=0.62), and lung cancer (HR=0.75), the researchers report in the Journal of Clinical Oncology.
Noting that their findings contradict earlier studies of autoimmune disease, Kim et al believe that “this discrepancy could be explained by the fact that patients with vitiligo are treated mainly with topical ointments and phototherapy, whereas systemic immunomodulatory drugs such as cyclosporine, methotrexate, and tumor necrosis factor inhibitors, which are commonly used to treat other autoimmune diseases, are not used for vitiligo.”
While acknowledging the study requires confirmation, especially among patients of other ethnicities, the team concludes: “The findings of this study could motivate physicians and researchers to investigate the systemic influence of the autoimmune nature of vitiligo.
“In addition, the development of de novo vitiligo associated with the use of [immune checkpoint inhibitors] could be approached from a different angle.”
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