Medication use and multiple myeloma risk in Los Angeles County
Menée aux Etats-Unis auprès de 278 cas et 278 témoins, cette étude évalue l'association entre l'utilisation d'érythromycine, un médicament antibiotique, et le risque de myélome multiple
Background : The role of medication use in multiple myeloma (MM) risk remains unclear. Methods : The Los Angeles County Multiple Myeloma Case–Control Study, comprising 278 MM cases and individually matched neighborhood controls, provided data to assess associations between medication use and MM risk. Odds ratios (OR) and 95 % confidence intervals (CI) were estimated using conditional logistic regression. Results : Erythromycin (ever) use was associated with increased MM risk (OR 1.85, 95 % CI 1.13–3.03). This association was restricted to men (OR 3.77, 95 % CI 1.72–8.29) and was especially apparent among men who took two or more courses of erythromycin (OR 4.68, 95 % CI 1.70–12.87). Conclusions : Compared to females, males have lower levels of cytochrome P450 3A4 (CYP3A4), for which erythromycin is both a substrate and inhibitor. Use of CYP3A4-inhibiting drugs such as erythromycin in men may thus result in even lower levels of CYP3A4 and, consequently, higher levels of CYP3A4-metabolized substances. These results could potentially provide clues to explain discrepancies in MM incidence by sex. Consortial efforts to confirm these associations are warranted.