{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:30:27Z","timestamp":1785429027694,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009945","name":"Merck KGaA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009945","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The objective was to compare the risk of malignancies in real\u2010world settings between exclusive immunosuppressant (IS) and immunomodulator (IM) use in multiple sclerosis (MS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nested case\u2013control study was designed within a new\u2010user cohort of all patients with MS who initiated a first IM or IS between 2008 and 2014, and without cancer history, using the information of the SNDS nationwide French claims database. Incident cancer cases were matched with up to six controls on year of birth, sex, initiation date, and disease risk score of cancer. A conditional logistic regression (odds ratio [95% confidence interval]) was used to compare exclusive IS versus IM use during follow\u2010up and according to three use durations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 28\u2009720 newly treated patients with MS, 407 incident cancers were observed during the follow\u2010up with 2324 matched controls. A significant increase in cancer risk was observed for IS compared with IM (1.36 [1.05, 1.77]), with similar increases for the first 2 years of use but not for \u22652\u2009years (1.06 [0.65, 1.75]). Similar increase was also observed for IS with indications other than MS (1.37 [1.04, 1.81]) but not for IS indicated only in MS (1.03 [0.45, 2.34]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with IM, a 37% increase in cancer risk was observed for IS with indications other than MS and used for a short duration (\u22642\u2009years) but not for IS indicated only in MS. The absence of risk for prolonged exposure of IS with indications other than MS is not in favor of a causal relation with these drugs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5669","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T09:34:41Z","timestamp":1691573681000},"page":"1421-1430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk of cancer with immunosuppressants compared to immunomodulators in multiple sclerosis: A nested case\u2013control study within the French nationwide claims database"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9763-5974","authenticated-orcid":false,"given":"Pauline","family":"Bosco\u2010L\u00e9vy","sequence":"first","affiliation":[{"name":"INSERM CIC\u2010P 1401, Bordeaux PharmacoEpi Universit\u00e9 de Bordeaux  Bordeaux 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