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Medication use and multiple myeloma risk in Los Angeles County

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Abstract

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.

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Acknowledgments

This work was supported by the National Cancer Institute R01CA036388, 5P30CA033572, and the City of Hope Beckman Research Institute. All authors assume responsibility for the data analysis and the content of the manuscript. We are indebted to the late Ronald K. Ross, M.D., who was the original principal investigator of the LAMMCC study. We would like to also thank Marcella A. Evans (University of California, Irvine), Thomas H. Taylor, Ph.D. (University of California, Irvine), Hoda Anton-Culver, Ph.D. (University of California, Irvine), and Paul H. Nuyujukian, M.D., Ph.D. (Stanford University) for their helpful suggestions and scientific input.

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Authors and Affiliations

  1. Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute of the City of Hope, 1500 East Duarte Road, Duarte, CA, 91010, USA

    Daniel S. Nuyujukian, Jenna Voutsinas, Leslie Bernstein & Sophia S. Wang

  2. Department of Epidemiology, School of Medicine, University of California, Irvine, 224 Irvine Hall, Irvine, CA, 92697, USA

    Daniel S. Nuyujukian

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  1. Daniel S. Nuyujukian
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  2. Jenna Voutsinas
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  3. Leslie Bernstein
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  4. Sophia S. Wang
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Corresponding author

Correspondence to Sophia S. Wang.

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Nuyujukian, D.S., Voutsinas, J., Bernstein, L. et al. Medication use and multiple myeloma risk in Los Angeles County. Cancer Causes Control 25, 1233–1237 (2014). https://doi.org/10.1007/s10552-014-0424-0

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  • DOI: https://doi.org/10.1007/s10552-014-0424-0

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