title: The effect of antiestrogen agents on risk of autoimmune disorders in patients with breast cancer.
abstract: OBJECTIVE
  To investigate the relationship between antiestrogen therapy in women with breast cancer and risk of autoimmune disease.
  
  
  METHODS
  We used a national database to assess the incidence of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) following treatment with selective estrogen receptor modulators (SERM) or aromatase inhibitors (AI) in women with breast cancer. The total number of patients in our study was 190,620.
  
  
  RESULTS
  We observed highly significant, cumulative dose-dependent increased OR of incidence of both SLE and RA following treatment with SERM (p < 0.0001). The odds of developing RA were also increased following AI therapy (p < 0.001), but there was a trend for reduced odds of SLE, though this trend did not attain statistical significance (p = 0.070 for 2-11 months of treatment and p = 0.254 for 12+ months of treatment).
  
  
  CONCLUSIONS
  Antiestrogen agents may have an important effect on risk of autoimmune disease.
authors.affiliation: From the Division of Rheumatology, Department of Medicine, MetroHealth Medical Center, Cleveland, Ohio, USA.J.Y. Chen, AB, Case Western Reserve University School of Medicine; S.P. Ballou, MD, Division of Rheumatology, Department of Medicine, MetroHealth Medical Center.
authors.forename: Jason Y
authors.initials: JY
authors.lastname: Chen
authors.affiliation: From the Division of Rheumatology, Department of Medicine, MetroHealth Medical Center, Cleveland, Ohio, USA.J.Y. Chen, AB, Case Western Reserve University School of Medicine; S.P. Ballou, MD, Division of Rheumatology, Department of Medicine, MetroHealth Medical Center. sballou@metrohealth.org.
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Ballou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000139:chemically induced / Q000453:epidemiology*; D001943:Breast Neoplasms / Q000188:drug therapy*; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D004965:Estrogen Antagonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced / Q000453:epidemiology*; D008875:Middle Aged; D012306:Risk; D055815:Young Adult
chemical_list: D004965:Estrogen Antagonists
keywords: AROMATASE INHIBITORS; AUTOIMMUNE DISEASES; ESTROGEN RECEPTOR-POSITIVE; RHEUMATOID ARTHRITIS; SELECTIVE ESTROGEN RECEPTOR MODULATORS; SYSTEMIC LUPUS ERYTHEMATOSUS