Table 4.
Summary of relative risks of MCC occurring after various forms of immunosuppression.
| Reference | Study Type (Country) | Mode of Immunosuppression | Findings a |
|---|---|---|---|
| Lanoy et al. 2010 [12] | Registry analysis. (USA) | Autoimmune disease (RA) | 79/1977 MCC patients had RA develop
Odds ratio, 1.39 (95% CI, 1.10–1.75) |
| Cirillo et al. 2012 [71] | Single-center analysis. (Italy) | Autoimmune disease (RA) | 3/48 patients with RA had MCC develop during immunosuppressant corticosteroid treatment Statistical significance not determined |
| Hemminki et al. 2012 [11] | Registry analysis (Sweden) | Autoimmune diseases (AS, IBS, CD, RA) | 3/112,541 patients with AS had MCC (SIR, 15.62; 95% CI, 2.95–46.25) 9/68,915 patients with IBS had MCC (SIR, 4.02; 95% CI, 1.82–7.66) 5/35,422 patients with CD had MCC (SIR, 4.38; 95% CI, 1.38–10.31) 7/71,963 patients with RA had MCC (SIR, 2.42; 95% CI, 0.96–5.01). |
| Engels et al. 2002 [13] | Registry analysis (USA) | AIDS | 6/30,9365 patients with AIDS had MCC (relative risk, 13.4; 95% CI, 4.9–29.1) |
| Lanoy et al. 2009 [125] | Registry analysis (USA) | AIDS | 17/497,142 male patients with AIDS had MCC (SIR, 11; 95% CI, 6.3–17) |
| Lunder and Stern. 1998 [63] | Multicenter analysis (USA) | UV-A phototherapy + psoralen | 3/1380 (0.2%) patients with psoriasis receiving UV-A + psoralen had MCC develop ~100-fold increase |
| Calzavara-Pinton et al. 2010 [64] | Retrospective analysis (Italy) | UV-A phototherapy | 2 immunosuppressed patients had MCC develop after UV-A1 phototherapy treatment
Statistical significance not determined |
| Sahi et al. 2012 [29] | Registry analysis, 1994–2009 (Finland) | Statins (HMG-CoA-reductase inhibitors) | 50/454,935 statin users had MCC develop
Age ≤60 y: SIR, 3.16; 95% CI, 0.65–9.23 Age 60–74 y: SIR, 1.94; 95% CI, 1.23–2.90 Age ≥75 y: SIR, 0.89; 95% CI, 0.67–0.92 |
| Howard et al. 2006 [22] | Registry analysis, 1986–2002 (USA) | Malignant melanoma | 16/70,604 patients with melanoma had MCC (SIR, 3.05; 95% CI, 1.74–4.95) |
Abbreviations: AS, ankylosing spondylitis; CD, Crohn disease; IBS, inflammatory bowel syndrome; MCC, Merkel cell carcinoma; RA, rheumatoid arthritis; SIR, standardized incidence ratio; USA, United States of America. a Statistically significant risk values are shown in boldface type.