Medical history of chemotherapy or immunosuppressive drug treatment and risk of amyotrophic lateral sclerosis (ALS)
A recent population-based analysis demonstrated lower risk of the lethal degenerative neuromuscular disease, amyotrophic lateral sclerosis (ALS) associated with history of the use of ‘antineoplastic agents’ and ‘immunosuppressants’. To see if this finding was generalizable to other ALS cohorts, we examined associations between use of these agents and ALS risk in an independent case–control study of n = 414 ALS patients and n = 361 controls in an Eastern US population. Controls were sampled from the general population and among non-neurodegenerative disease patients. A history of chemotherapy treatment was significantly associated with a decreased ALS risk (OR 0.46, 95% CI 0.22–0.89, P = 0.026). We did not observe an association between risk of ALS and immunosuppressant therapy use (OR 0.78, 95% CI 0.50–1.02, P = 0.23). Analyses were adjusted for age, gender, and smoking. Our results support the prior report for chemotherapy treatment and lead to further discussion of the underlying mechanism.
KeywordsAmyotrophic lateral sclerosis Case–control Chemotherapy Immunosuppressant Neurodegenerative
We would like to thank the study participants and our sources of funding: ALS Association grants SC5181 and 15-IIP-213; Centers for Disease Control (CDC)/Agency for Toxic Substances and Disease Registry (ATSDR) R01TS1000245 and contract 200-2014-59046; the Dartmouth Clinical and Translational Science Institute, under award number UL1TR001086 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH).
Compliance with ethical standards
All study procedures were approved by the Committee for Protection of Human Subjects at Dartmouth College, the Committee on Human Research in the Medical Sciences at the University of Vermont, and the Office of Human Subjects Research at Johns Hopkins Medicine. All data was collected from patients who consented to participation in the study.
Conflicts of interest
The authors declare that they have no conflict of interest.
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