title: Relative risk of myelodysplastic syndromes in patients with autoimmune disorders in the General Practice Research Database.
abstract: BACKGROUND
  Certain immunosuppressant drugs are known to increase the risk of myeloid neoplasms although it is unclear if underlying autoimmune disorder itself increases the risk of myeloid neoplasms.
  
  
  METHODS
  Using a nested case-control study in the General Practice Research Database (GPRD), we estimated the relative risk of myeloid neoplasms, specifically myelodysplastic syndromes (MDS) in patients with autoimmune disorders compared with patients without autoimmune disorders.
  
  
  RESULTS
  We identified 849 cases of MDS and 3417 matched controls. There was a slightly increased risk of MDS in patients with any autoimmune disorder (adjusted OR 1.5, 95% CI 1.1, 2.0), which was limited to patients diagnosed over 10 years prior to the index date (adjusted OR 2.1, 95% CI 1.4, 3.2). The elevated odds ratios of MDS were present in both untreated patients and patients who had a record of receiving multiple treatments.
  
  
  CONCLUSIONS
  There was a modestly increased risk of MDS was in patients with a history of autoimmune disorder. However, it is difficult to determine whether autoimmune disorders increased the risk of MDS, or whether the small elevation in the risk estimate was an artifact of misdiagnosis resulting from early MDS symptoms similar to those of autoimmune disorders.
  
  
  CONCLUSIONS
  These findings may indicate the increased need for MDS screening in patients with autoimmune disease, and further research regarding MDS etiology.
authors.affiliation: Epidemiology Department, Boston University School of Public Health, Boston, MA 02118, United States. Electronic address: AmandaABW@gmail.com.
authors.forename: Amanda B
authors.initials: AB
authors.lastname: Wilson
authors.affiliation: Clinical Epidemiology Unit and Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, United States.
authors.forename: Tuhina
authors.initials: T
authors.lastname: Neogi
authors.affiliation: Epidemiology Department, Boston University School of Public Health, Boston, MA 02118, United States.
authors.forename: Marianne
authors.initials: M
authors.lastname: Prout
authors.affiliation: Epidemiology Department, Boston University School of Public Health, Boston, MA 02118, United States; Boston Collaborative Drug Surveillance Program, Boston University, Lexington, MA 02421, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Jick
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000150:complications / Q000453:epidemiology*; D016022:Case-Control Studies; D016208:Databases, Factual; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012306:Risk; D055815:Young Adult
keywords: Autoimmune disorders; Myelodysplastic syndromes; Myeloid neoplasms