High risk of cancer in autoimmune necrotizing myopathies: usefulness of myositis specific antibody

Abstract : Cancer occurs frequently in dermatomyositis and is a major cause of mortality. Yves Allenbach et al. report that patients with necrotising auto-immune myopathies also have an increased risk of malignancy, and that myositis-specific antibodies can be used to identify those at greatest risk.Cancer occurs frequently in dermatomyositis and is a major cause of mortality. Yves Allenbach et al. report that patients with necrotising auto-immune myopathies also have an increased risk of malignancy, and that myositis-specific antibodies can be used to identify those at greatest risk.Cancer can occur in patients with inflammatory myopathies. This association is mainly observed in dermatomyositis, and myositis-specific antibodies have allowed us to delineate patients at an increased risk. Malignancy is also reported in patients with necrotizing autoimmune myopathies, but the risk remains elusive. Anti-signal recognition particle or anti-HMGCR antibodies have been specifically associated with necrotizing autoimmune myopathies. We aimed at screening the incidence of cancer in necrotizing autoimmune myopathies. A group of patients (n = 115) with necrotizing autoimmune myopathies with or without myositis-specific antibodies was analysed. Malignancy occurred more frequently in seronegative necrotizing autoimmune myopathies patients and in HMGCR-positive patients compared to anti-signal recognition particle positive patients. Synchronous malignancy was diagnosed in 21.4% and 11.5% of cases, respectively, and incidence of cancer was higher compared to the general population in both groups. No specific type of cancer was predominant. Patients suffering from a synchronous cancer had a decreased median survival time. Cancer screening is necessary in seronegative necrotizing autoimmune myopathies and in HMGCR-positive patients but not in anti-signal recognition particle-positive patients.