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Medscape
5 days ago
- Health
- Medscape
Type II Vasculitis Signals Poor Prognosis in Sjögren Disease
TOPLINE: Among patients with primary Sjögren disease, type II cryoglobulinemic vasculitis is linked to an increased risk for lymphoma and mortality, a French study showed. METHODOLOGY: Researchers conducted a retrospective multicenter cohort study of 54 patients with primary Sjögren disease and cutaneous vasculitis (CV) from three pathology departments in Paris and a national case call in France (median age, 42 years; 91% women). Patients were diagnosed with CV between 2011 and 2021; 29 (57%) had cryoglobulinemic vasculitis and 15 (28%) had hypergammaglobulinemic vasculitis; 24 of the 29 cryoglobulinemic cases were type II. Data were analyzed between March 2023 and March 2025. Patients were matched 1:2 to 108 controls with Sjögren disease but without CV from the French ASSESS cohort. Primary outcomes of the study were the occurrence of lymphoma diagnosis and mortality risk. TAKEAWAY: Patients with Sjögren disease and CV showed a higher lymphoma incidence than those without CV (13% vs 4%; P = .04). Patients with type II cryoglobulinemic vasculitis had a significantly higher incidence of lymphoma (21% vs 0%; P = .02) and increased mortality (29% vs 0; P = .02) than those with other types of small-vessel vasculitis. The risk for death or non-Hodgkin lymphoma was increased by nearly sevenfold risk in patients with type II cryoglobulinemic vasculitis (hazard ratio [HR], 6.8; P = .005) compared with other CV types. Patients with type II cryoglobulinemic vasculitis were more likely to have subacute cutaneous lupus (21% vs 0%; P = .02), kidney involvement (29% vs 4%; P = .02) and peripheral nervous system involvement (63% vs 12%; P < .001) than those with other CV types. Among 24 patients with type II cryoglobulinemic vasculitis, 12 received rituximab-based first-line treatment; non-Hodgkin lymphoma developed in 8% of patients in the rituximab group and in 25% of those who received other treatments, whereas mortality rates were 33% and 25%, respectively. IN PRACTICE: 'In this cohort study, among patients with CV-complicated Sjögren disease, only type II cryoglobulinemic vasculitis was associated with severe visceral involvement, higher risk of non-Hodgkin lymphoma, and mortality,' the study authors wrote. These findings, they added, highlighted the need for 'specific monitoring for these patients.' SOURCE: The study was led by Paul Breillat, MD, INSERM, Paris Centre de Recherche Cardiovasculaire, Paris, France, and was published online on August 6 in JAMA Dermatology. LIMITATIONS: The retrospective design and potential missing data could affect the interpretation of results. Additionally, half of the patients were diagnosed with CV on the basis of clinical criteria. DISCLOSURES: The ASSESS cohort was set up with a grant from the French Ministry of Health. One author reported receiving personal fees from Bristol Myers Squibb, GSK, Novartis, and Otsuka; another author reported receiving grants from AstraZeneca, Bristol Myers Squibb, and GSK. No other disclosures were reported. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Fox News
19-06-2025
- Health
- Fox News
Cannabis use raises risk of heart attack and stroke more than cocaine, other drugs, major review suggests
The potential risk of cannabis use has been in the spotlight following recent research pointing toward negative health effects. This includes a new meta-analysis by French researchers, published in the journal Heart, which reviewed multiple studies to assess the link between cannabis and major adverse cardiovascular events (MACE). The researchers analyzed data from more than 400 million patients involved in 24 previous cross-sectional studies (capturing data at a single point in time) and cohort studies (following patients over time). One study focused on medical cannabis. The overall results noted a significant increase in risk of major cardiovascular events, including a 29% higher likelihood of heart attack, 20% higher risk of stroke and twice the chances of cardiovascular death. The danger was also elevated in people who used cannabis at least once a week. Several studies found higher odds of acute myocardial infarction, commonly known as a heart attack. One study pinpointed the risk among younger populations aged 15 to 22, while another observed it in patients who used cannabis more than once a week. One study from the primary French administrative database for hospitals found that, compared to other illicit drugs like cocaine and opioids, cannabis was a larger predictor of heart attack. Another study analyzed the association between cannabis and acute coronary syndrome (reduced blood flow to the heart) in nearly 15,000 patients ranging from 18 to 54 years old. The analysis found no significant association in the overall sample, but signaled a higher risk in a subgroup of patients aged 18 to 36. Cannabis use significantly increased all-cause mortality and cardiovascular mortality in a cohort of patients who experienced a heart attack before age 50. A UK Biobank analysis pointed out that women have a "significantly higher" risk of cardiovascular mortality than men. The larger review concluded that these findings reveal "positive associations" between cannabis use and MACE, and should "encourage investigating cannabis use in all patients presenting with serious cardiovascular disorders." Although medical marijuana can provide relief for people with conditions like arthritis, multiple sclerosis, cancer and other illnesses, overuse has been linked to potential health risks, especially for seniors. The authors of the French review acknowledged that there were some limitations to the findings – primarily that there is a lower prevalence of cocaine and opioids compared to cannabis use. "Cannabis exposure was poorly reported in the included studies, which prevented our meta-analysis from assessing it," they wrote. There was also a potential for some degree of bias in some of the studies due to lack of information or missing data. "Studies that relied on patient surveys faced substantial bias regarding exposure and outcome misclassification when patients assessed these data themselves," the researchers noted. Other potential limitations included overlapping data and limited timeframes. During an appearance on "America's Newsroom" in early June, Fox News senior medical analyst Dr. Marc Siegel commented on a recent study that found more seniors are using cannabis than ever before, despite the potential health risks. Siegel noted that regular use of cannabis can be dangerous if not tracked. "We definitely jumped the gun by not anticipating all the medical risks here." "You might use a gummy to go to bed, and then the next thing, you're using two gummies, or three gummies, and it could increase anxiety, it can increase discombobulation, you're not thinking clearly, ER visits are on the increase," he cautioned. "We know about problems with the lungs," Siegel added. "It can accelerate dementia and can affect behavior." The doctor likened the use of marijuana to the effects of smoking cigarettes in terms of damage to the heart and lungs. "It is absolutely an active chemical we need to watch out for, and I'm very disturbed that the elderly are using it," he said. "We've completely jumped the gun [on legalization] because people are going to the ER with psychosis. They're going there with vomiting disorders. They're having car accidents as a result," he went on. For more Health articles, visit "We are studying Colorado ever since it was legalized there, and the results are not pretty. We definitely jumped the gun by not anticipating all the medical risks here." Fox News Digital reached out to the study authors for comment.
