INCREASED RISK OF AGE-RELATED MACULAR DEGENERATION IN PATIENTS WITH PHILADELPHIA-NEGATIVE CHRONIC MYELOPROLIFERATIVE NEOPLASMS
(Abstract release date: 05/19/16)
EHA Library. Bak M. 06/09/16; 132904; E1355
Ms. Marie Bak
Contributions
Contributions
Abstract
Abstract: E1355
Type: Eposter Presentation
Background
Patients with Philadelphia (Ph) -negative chronic myeloproliferative neoplasms (MPNs) can experience visual symptoms which are caused by microcirculatory disturbances, but the risk of other ophthalmic manifestations such as age-related macular degeneration (AMD) is unknown. AMD causes progressive loss of the central vision and it is the most common cause of blindness in elderly in western countries. Chronic inflammation is involved in the development and progression of both AMD and MPNs, and similar inflammatory pathways are dysregulated. Our previous findings suggest that patients with Ph-negative MPNs have increased prevalence of AMD at time of diagnosis. The potential link between the diseases is possibly explained by the degree of systemic inflammation in patients with MPNs, which may predispose some individuals to develop AMD.
Aims
To determine the risk of AMD in patients with essential thrombocythemia (ET), polycythemia vera (PV), myelofibrosis (MF) and unclassifiable MPN (MPN-U) compared to the general population
Methods
We undertook an observational matched cohort study and included patients diagnosed with Ph-negative MPNs in Denmark between 1994 and 2013. We included nationwide cohorts of patients with ET, PV, MF and MPN-U by using population-based registries. To compare the risk of AMD, we identified 10 individually sex-and-age matched comparisons from the general population for each patient. We excluded patients and comparisons who had a prior AMD diagnosis or a follow-up time of less than 30 days after the MPN was diagnosed. Everyone was followed until death, December 31, 2013, or until they were diagnosed with any AMD diagnosis at a hospital. Cox proportional hazards models were used to estimate the hazard ratio (HR) of AMD in patients with Ph-negative MPNs (ET, PV, MF, MPN-U) as well as separately for each MPN subgroup. We adjusted for smoking (proxy measure used by including smoking related diagnoses from the Danish National Patient Registry) as smoking is a risk factor for developing AMD. Additionally, we also adjusted for risk-time (1994-2001, 2002-2006, 2007-2013), since new AMD treatments were introduced in Danish hospitals in 2002 and 2007. This could imply that individuals were more likely to be diagnosed with AMD at hospitals after these treatments had been introduced.
Results
We included 7 958 patients with Ph-negative MPNs and 77 445 sex-and-age matched comparisons in the study, after 365 patients and 2 619 comparisons had been excluded. Of the excluded individuals, 222 patients (1 907 comparisons) had a prior AMD diagnosis and 143 patients (712 comparisons) had a follow-up time of less than 30 days. In total, we included: ET=2 628; PV=3 063; MF=547 and MPN-U=1 720 patients. Significant more patients with ET, PV and MPN-U had smoking-related diagnoses compared to comparisons (p<0.05), but no difference was seen for patients with MF. Smoking was associated with an increased risk of AMD in both patients and comparisons.We found an increased risk of AMD in patients with Ph-negative MPNs (ET, PV, MF, MPN-U), adjusted hazard ratio (HR) [95% confidence interval] =1.28 [1.10-1.48]. Subset analyses of the HR in each MPN subgroup revealed an increased risk of AMD in each group, but the risk was only significantly increased in patients with PV. The smoking and risk-time adjusted HR (95 % CI) was 1.15 [0.88-1.49] for ET; 1.42 [1.15-1.76] for PV; 1.54 [0.67-3.53] for MF and 1.33 [0.93-1.88] for MPN-U.
Conclusion
Our study indicates that patients with Ph-negative MPNs have increased risk of AMD compared to the general population. We speculate that the increased risk is caused by chronic inflammation, but further studies are needed to investigate the potential causal relationship.
Session topic: E-poster
Keyword(s): Comorbidities, Epidemiology, Inflammation, Myeloproliferative disorder
Type: Eposter Presentation
Background
Patients with Philadelphia (Ph) -negative chronic myeloproliferative neoplasms (MPNs) can experience visual symptoms which are caused by microcirculatory disturbances, but the risk of other ophthalmic manifestations such as age-related macular degeneration (AMD) is unknown. AMD causes progressive loss of the central vision and it is the most common cause of blindness in elderly in western countries. Chronic inflammation is involved in the development and progression of both AMD and MPNs, and similar inflammatory pathways are dysregulated. Our previous findings suggest that patients with Ph-negative MPNs have increased prevalence of AMD at time of diagnosis. The potential link between the diseases is possibly explained by the degree of systemic inflammation in patients with MPNs, which may predispose some individuals to develop AMD.
Aims
To determine the risk of AMD in patients with essential thrombocythemia (ET), polycythemia vera (PV), myelofibrosis (MF) and unclassifiable MPN (MPN-U) compared to the general population
Methods
We undertook an observational matched cohort study and included patients diagnosed with Ph-negative MPNs in Denmark between 1994 and 2013. We included nationwide cohorts of patients with ET, PV, MF and MPN-U by using population-based registries. To compare the risk of AMD, we identified 10 individually sex-and-age matched comparisons from the general population for each patient. We excluded patients and comparisons who had a prior AMD diagnosis or a follow-up time of less than 30 days after the MPN was diagnosed. Everyone was followed until death, December 31, 2013, or until they were diagnosed with any AMD diagnosis at a hospital. Cox proportional hazards models were used to estimate the hazard ratio (HR) of AMD in patients with Ph-negative MPNs (ET, PV, MF, MPN-U) as well as separately for each MPN subgroup. We adjusted for smoking (proxy measure used by including smoking related diagnoses from the Danish National Patient Registry) as smoking is a risk factor for developing AMD. Additionally, we also adjusted for risk-time (1994-2001, 2002-2006, 2007-2013), since new AMD treatments were introduced in Danish hospitals in 2002 and 2007. This could imply that individuals were more likely to be diagnosed with AMD at hospitals after these treatments had been introduced.
Results
We included 7 958 patients with Ph-negative MPNs and 77 445 sex-and-age matched comparisons in the study, after 365 patients and 2 619 comparisons had been excluded. Of the excluded individuals, 222 patients (1 907 comparisons) had a prior AMD diagnosis and 143 patients (712 comparisons) had a follow-up time of less than 30 days. In total, we included: ET=2 628; PV=3 063; MF=547 and MPN-U=1 720 patients. Significant more patients with ET, PV and MPN-U had smoking-related diagnoses compared to comparisons (p<0.05), but no difference was seen for patients with MF. Smoking was associated with an increased risk of AMD in both patients and comparisons.We found an increased risk of AMD in patients with Ph-negative MPNs (ET, PV, MF, MPN-U), adjusted hazard ratio (HR) [95% confidence interval] =1.28 [1.10-1.48]. Subset analyses of the HR in each MPN subgroup revealed an increased risk of AMD in each group, but the risk was only significantly increased in patients with PV. The smoking and risk-time adjusted HR (95 % CI) was 1.15 [0.88-1.49] for ET; 1.42 [1.15-1.76] for PV; 1.54 [0.67-3.53] for MF and 1.33 [0.93-1.88] for MPN-U.
Conclusion
Our study indicates that patients with Ph-negative MPNs have increased risk of AMD compared to the general population. We speculate that the increased risk is caused by chronic inflammation, but further studies are needed to investigate the potential causal relationship.
Session topic: E-poster
Keyword(s): Comorbidities, Epidemiology, Inflammation, Myeloproliferative disorder
Abstract: E1355
Type: Eposter Presentation
Background
Patients with Philadelphia (Ph) -negative chronic myeloproliferative neoplasms (MPNs) can experience visual symptoms which are caused by microcirculatory disturbances, but the risk of other ophthalmic manifestations such as age-related macular degeneration (AMD) is unknown. AMD causes progressive loss of the central vision and it is the most common cause of blindness in elderly in western countries. Chronic inflammation is involved in the development and progression of both AMD and MPNs, and similar inflammatory pathways are dysregulated. Our previous findings suggest that patients with Ph-negative MPNs have increased prevalence of AMD at time of diagnosis. The potential link between the diseases is possibly explained by the degree of systemic inflammation in patients with MPNs, which may predispose some individuals to develop AMD.
Aims
To determine the risk of AMD in patients with essential thrombocythemia (ET), polycythemia vera (PV), myelofibrosis (MF) and unclassifiable MPN (MPN-U) compared to the general population
Methods
We undertook an observational matched cohort study and included patients diagnosed with Ph-negative MPNs in Denmark between 1994 and 2013. We included nationwide cohorts of patients with ET, PV, MF and MPN-U by using population-based registries. To compare the risk of AMD, we identified 10 individually sex-and-age matched comparisons from the general population for each patient. We excluded patients and comparisons who had a prior AMD diagnosis or a follow-up time of less than 30 days after the MPN was diagnosed. Everyone was followed until death, December 31, 2013, or until they were diagnosed with any AMD diagnosis at a hospital. Cox proportional hazards models were used to estimate the hazard ratio (HR) of AMD in patients with Ph-negative MPNs (ET, PV, MF, MPN-U) as well as separately for each MPN subgroup. We adjusted for smoking (proxy measure used by including smoking related diagnoses from the Danish National Patient Registry) as smoking is a risk factor for developing AMD. Additionally, we also adjusted for risk-time (1994-2001, 2002-2006, 2007-2013), since new AMD treatments were introduced in Danish hospitals in 2002 and 2007. This could imply that individuals were more likely to be diagnosed with AMD at hospitals after these treatments had been introduced.
Results
We included 7 958 patients with Ph-negative MPNs and 77 445 sex-and-age matched comparisons in the study, after 365 patients and 2 619 comparisons had been excluded. Of the excluded individuals, 222 patients (1 907 comparisons) had a prior AMD diagnosis and 143 patients (712 comparisons) had a follow-up time of less than 30 days. In total, we included: ET=2 628; PV=3 063; MF=547 and MPN-U=1 720 patients. Significant more patients with ET, PV and MPN-U had smoking-related diagnoses compared to comparisons (p<0.05), but no difference was seen for patients with MF. Smoking was associated with an increased risk of AMD in both patients and comparisons.We found an increased risk of AMD in patients with Ph-negative MPNs (ET, PV, MF, MPN-U), adjusted hazard ratio (HR) [95% confidence interval] =1.28 [1.10-1.48]. Subset analyses of the HR in each MPN subgroup revealed an increased risk of AMD in each group, but the risk was only significantly increased in patients with PV. The smoking and risk-time adjusted HR (95 % CI) was 1.15 [0.88-1.49] for ET; 1.42 [1.15-1.76] for PV; 1.54 [0.67-3.53] for MF and 1.33 [0.93-1.88] for MPN-U.
Conclusion
Our study indicates that patients with Ph-negative MPNs have increased risk of AMD compared to the general population. We speculate that the increased risk is caused by chronic inflammation, but further studies are needed to investigate the potential causal relationship.
Session topic: E-poster
Keyword(s): Comorbidities, Epidemiology, Inflammation, Myeloproliferative disorder
Type: Eposter Presentation
Background
Patients with Philadelphia (Ph) -negative chronic myeloproliferative neoplasms (MPNs) can experience visual symptoms which are caused by microcirculatory disturbances, but the risk of other ophthalmic manifestations such as age-related macular degeneration (AMD) is unknown. AMD causes progressive loss of the central vision and it is the most common cause of blindness in elderly in western countries. Chronic inflammation is involved in the development and progression of both AMD and MPNs, and similar inflammatory pathways are dysregulated. Our previous findings suggest that patients with Ph-negative MPNs have increased prevalence of AMD at time of diagnosis. The potential link between the diseases is possibly explained by the degree of systemic inflammation in patients with MPNs, which may predispose some individuals to develop AMD.
Aims
To determine the risk of AMD in patients with essential thrombocythemia (ET), polycythemia vera (PV), myelofibrosis (MF) and unclassifiable MPN (MPN-U) compared to the general population
Methods
We undertook an observational matched cohort study and included patients diagnosed with Ph-negative MPNs in Denmark between 1994 and 2013. We included nationwide cohorts of patients with ET, PV, MF and MPN-U by using population-based registries. To compare the risk of AMD, we identified 10 individually sex-and-age matched comparisons from the general population for each patient. We excluded patients and comparisons who had a prior AMD diagnosis or a follow-up time of less than 30 days after the MPN was diagnosed. Everyone was followed until death, December 31, 2013, or until they were diagnosed with any AMD diagnosis at a hospital. Cox proportional hazards models were used to estimate the hazard ratio (HR) of AMD in patients with Ph-negative MPNs (ET, PV, MF, MPN-U) as well as separately for each MPN subgroup. We adjusted for smoking (proxy measure used by including smoking related diagnoses from the Danish National Patient Registry) as smoking is a risk factor for developing AMD. Additionally, we also adjusted for risk-time (1994-2001, 2002-2006, 2007-2013), since new AMD treatments were introduced in Danish hospitals in 2002 and 2007. This could imply that individuals were more likely to be diagnosed with AMD at hospitals after these treatments had been introduced.
Results
We included 7 958 patients with Ph-negative MPNs and 77 445 sex-and-age matched comparisons in the study, after 365 patients and 2 619 comparisons had been excluded. Of the excluded individuals, 222 patients (1 907 comparisons) had a prior AMD diagnosis and 143 patients (712 comparisons) had a follow-up time of less than 30 days. In total, we included: ET=2 628; PV=3 063; MF=547 and MPN-U=1 720 patients. Significant more patients with ET, PV and MPN-U had smoking-related diagnoses compared to comparisons (p<0.05), but no difference was seen for patients with MF. Smoking was associated with an increased risk of AMD in both patients and comparisons.We found an increased risk of AMD in patients with Ph-negative MPNs (ET, PV, MF, MPN-U), adjusted hazard ratio (HR) [95% confidence interval] =1.28 [1.10-1.48]. Subset analyses of the HR in each MPN subgroup revealed an increased risk of AMD in each group, but the risk was only significantly increased in patients with PV. The smoking and risk-time adjusted HR (95 % CI) was 1.15 [0.88-1.49] for ET; 1.42 [1.15-1.76] for PV; 1.54 [0.67-3.53] for MF and 1.33 [0.93-1.88] for MPN-U.
Conclusion
Our study indicates that patients with Ph-negative MPNs have increased risk of AMD compared to the general population. We speculate that the increased risk is caused by chronic inflammation, but further studies are needed to investigate the potential causal relationship.
Session topic: E-poster
Keyword(s): Comorbidities, Epidemiology, Inflammation, Myeloproliferative disorder
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