Medical history of chemotherapy or immunosuppressive drug treatment and risk of amyotrophic lateral sclerosis (ALS)

J Neurol. 2017 Aug;264(8):1763-1767. doi: 10.1007/s00415-017-8564-2. Epub 2017 Jul 15.

Abstract

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.

Keywords: Amyotrophic lateral sclerosis; Case–control; Chemotherapy; Immunosuppressant; Neurodegenerative.

MeSH terms

  • Age Factors
  • Amyotrophic Lateral Sclerosis / epidemiology*
  • Antineoplastic Agents* / adverse effects
  • Antineoplastic Agents* / therapeutic use
  • Case-Control Studies
  • Female
  • Humans
  • Immunosuppressive Agents* / adverse effects
  • Immunosuppressive Agents* / therapeutic use
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Sex Factors
  • Smoking / epidemiology
  • Vereinigte Staaten

Substances

  • Antineoplastic Agents
  • Immunosuppressive Agents