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Association Between Autoimmune Diseases and Monoclonal Gammopathy of Undetermined Significance : An Analysis From a Population-Based Screening Study

Sverrisdottir, Ingigerdur ; Thorsteinsdottir, Sigrun ; Rognvaldsson, Sæmundur ; Aspelund, Thor ; Vidarsson, Brynjar ; Onundarson, Pall Torfi ; Agnarsson, Bjarni A ; Sigurdardottir, Margret ; Thorsteinsdóttir, Ingunn and Sveinsdottir, Signy Vala LU , et al. (2024) In Annals of Internal Medicine 177(6). p.711-718
Abstract

BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) is a precursor of multiple myeloma (MM) and related conditions. In previous registry-based, retrospective studies, autoimmune diseases have been associated with MGUS. However, these studies were not based on a screened population and are therefore prone to ascertainment bias.

OBJECTIVE: To examine whether MGUS is associated with autoimmune diseases.

DESIGN: A cross-sectional study within iStopMM (Iceland Screens, Treats, or Prevents MM), a prospective, population-based screening study of MGUS.

SETTING: Icelandic population of adults aged 40 years or older.

PATIENTS: 75 422 persons screened for MGUS.

MEASUREMENTS: Poisson regression for... (More)

BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) is a precursor of multiple myeloma (MM) and related conditions. In previous registry-based, retrospective studies, autoimmune diseases have been associated with MGUS. However, these studies were not based on a screened population and are therefore prone to ascertainment bias.

OBJECTIVE: To examine whether MGUS is associated with autoimmune diseases.

DESIGN: A cross-sectional study within iStopMM (Iceland Screens, Treats, or Prevents MM), a prospective, population-based screening study of MGUS.

SETTING: Icelandic population of adults aged 40 years or older.

PATIENTS: 75 422 persons screened for MGUS.

MEASUREMENTS: Poisson regression for prevalence ratios (PRs) of MGUS among persons with or without an autoimmune disease, adjusted for age and sex.

RESULTS: A total of 10 818 participants had an autoimmune disorder, of whom 599 had MGUS (61 with a prior clinical diagnosis and 538 diagnosed at study screening or evaluation). A diagnosis of an autoimmune disease was not associated with MGUS (PR, 1.05 [95% CI, 0.97 to 1.15]). However, autoimmune disease diagnoses were associated with a prior clinical diagnosis of MGUS (PR, 2.11 [CI, 1.64 to 2.70]).

LIMITATION: Registry data were used to gather information on autoimmune diseases, and the homogeneity of the Icelandic population may limit the generalizability of these results.

CONCLUSION: The study did not find an association between autoimmune disease and MGUS in a systematically screened population. Previous studies not done in systematically screened populations have likely been subject to ascertainment bias. The findings indicate that recommendations to routinely screen patients with autoimmune disease for MGUS may not be warranted.

PRIMARY FUNDING SOURCE: The International Myeloma Foundation and the European Research Council.

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publishing date
type
Contribution to journal
publication status
published
keywords
Humans, Autoimmune Diseases/epidemiology, Male, Female, Monoclonal Gammopathy of Undetermined Significance/epidemiology, Iceland/epidemiology, Middle Aged, Cross-Sectional Studies, Aged, Adult, Mass Screening/methods, Prevalence, Prospective Studies
in
Annals of Internal Medicine
volume
177
issue
6
pages
711 - 718
publisher
American College of Physicians
external identifiers
  • scopus:85196489373
  • pmid:38768457
ISSN
0003-4819
DOI
10.7326/M23-2867
language
English
LU publication?
no
id
481517af-823b-4a7c-8349-4c8db869e227
date added to LUP
2024-12-06 14:46:25
date last changed
2025-07-05 21:37:47
@article{481517af-823b-4a7c-8349-4c8db869e227,
  abstract     = {{<p>BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) is a precursor of multiple myeloma (MM) and related conditions. In previous registry-based, retrospective studies, autoimmune diseases have been associated with MGUS. However, these studies were not based on a screened population and are therefore prone to ascertainment bias.</p><p>OBJECTIVE: To examine whether MGUS is associated with autoimmune diseases.</p><p>DESIGN: A cross-sectional study within iStopMM (Iceland Screens, Treats, or Prevents MM), a prospective, population-based screening study of MGUS.</p><p>SETTING: Icelandic population of adults aged 40 years or older.</p><p>PATIENTS: 75 422 persons screened for MGUS.</p><p>MEASUREMENTS: Poisson regression for prevalence ratios (PRs) of MGUS among persons with or without an autoimmune disease, adjusted for age and sex.</p><p>RESULTS: A total of 10 818 participants had an autoimmune disorder, of whom 599 had MGUS (61 with a prior clinical diagnosis and 538 diagnosed at study screening or evaluation). A diagnosis of an autoimmune disease was not associated with MGUS (PR, 1.05 [95% CI, 0.97 to 1.15]). However, autoimmune disease diagnoses were associated with a prior clinical diagnosis of MGUS (PR, 2.11 [CI, 1.64 to 2.70]).</p><p>LIMITATION: Registry data were used to gather information on autoimmune diseases, and the homogeneity of the Icelandic population may limit the generalizability of these results.</p><p>CONCLUSION: The study did not find an association between autoimmune disease and MGUS in a systematically screened population. Previous studies not done in systematically screened populations have likely been subject to ascertainment bias. The findings indicate that recommendations to routinely screen patients with autoimmune disease for MGUS may not be warranted.</p><p>PRIMARY FUNDING SOURCE: The International Myeloma Foundation and the European Research Council.</p>}},
  author       = {{Sverrisdottir, Ingigerdur and Thorsteinsdottir, Sigrun and Rognvaldsson, Sæmundur and Aspelund, Thor and Vidarsson, Brynjar and Onundarson, Pall Torfi and Agnarsson, Bjarni A and Sigurdardottir, Margret and Thorsteinsdóttir, Ingunn and Sveinsdottir, Signy Vala and Palmason, Robert and Olafsson, Isleifur and Sigurdsson, Fridbjorn and Thordardóttir, Asdis Rosa and Eythorsson, Elias and Jonsson, Asbjorn and Palsson, Runolfur and Indridason, Olafur Skuli and Gislason, Gauti Kjartan and Olafsson, Andri and Sigurdsson, Jon and Steingrímsdóttir, Hlif and Einarsson Long, Thorir and Hultcrantz, Malin and Durie, Brian G M and Harding, Stephen and Landgren, Ola and Kristinsson, Sigurdur Yngvi and Love, Thorvardur Jon}},
  issn         = {{0003-4819}},
  keywords     = {{Humans; Autoimmune Diseases/epidemiology; Male; Female; Monoclonal Gammopathy of Undetermined Significance/epidemiology; Iceland/epidemiology; Middle Aged; Cross-Sectional Studies; Aged; Adult; Mass Screening/methods; Prevalence; Prospective Studies}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{711--718}},
  publisher    = {{American College of Physicians}},
  series       = {{Annals of Internal Medicine}},
  title        = {{Association Between Autoimmune Diseases and Monoclonal Gammopathy of Undetermined Significance : An Analysis From a Population-Based Screening Study}},
  url          = {{http://dx.doi.org/10.7326/M23-2867}},
  doi          = {{10.7326/M23-2867}},
  volume       = {{177}},
  year         = {{2024}},
}