Medication use and multiple myeloma risk in Los Angeles County
Daniel S Nuyujukian1, Jenna Voutsinas, Leslie Bernstein
1Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute of the City of Hope, 1500 East Duarte Road, Duarte, CA, 91010, USA.
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.
Insights
Erythromycin use may increase multiple myeloma (MM) risk, particularly in men. This association might be linked to lower male levels of cytochrome P450 3A4 (CYP3A4), an enzyme affected by this antibiotic.
Area of Science:
- Oncology
- Pharmacology
- Epidemiology
Background:
- The relationship between medication use and multiple myeloma (MM) risk is not well-established.
- Understanding medication's role in MM etiology is crucial for risk assessment and prevention.
Purpose of the Study:
- To investigate the association between medication use and the risk of developing multiple myeloma.
- To explore potential sex-specific differences in this association.
Main Methods:
- A case-control study was conducted using data from the Los Angeles County Multiple Myeloma Case-Control Study.
- The study included 278 MM cases and matched neighborhood controls.
- Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for medication use and MM risk.
Main Results:
- Erythromycin use was associated with an increased risk of MM (OR 1.85).
- This association was predominantly observed in men (OR 3.77), especially those with multiple courses of erythromycin (OR 4.68).
Conclusions:
- Men have lower levels of cytochrome P450 3A4 (CYP3A4), an enzyme that metabolizes erythromycin.
- Erythromycin's inhibition of CYP3A4 in men may lead to elevated levels of other substances, potentially explaining sex disparities in MM incidence.
- Further research is needed to confirm these findings and their implications.
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