Fingolimod and risk of skin cancer among individuals with multiple sclerosis: a population-based cohort study protocol

Introduction Long-term population-based safety studies, applying advanced causal inference techniques, including an active comparator with new-user design, are needed to investigate skin cancer outcomes among individuals with multiple sclerosis (MS) treated with fingolimod. This study aims to descri...

Full description

Saved in:
Bibliographic Details
Main Authors: Lisa Kuramoto, Larry D Lynd, Amir Khakban, Jacquelyn J Cragg, Anthony Traboulsee, Jiwon Oh, Analisa Jia, Weng Sut Sio, M A De Vera, Jonathan Loree, Roger Tam
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e088924.full
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction Long-term population-based safety studies, applying advanced causal inference techniques, including an active comparator with new-user design, are needed to investigate skin cancer outcomes among individuals with multiple sclerosis (MS) treated with fingolimod. This study aims to describe a protocol for investigating the relationship between fingolimod use and the incidence of skin cancer among individuals with MS.Methods and analysis We will use population-based administrative health data from two Canadian provinces (British Columbia and Alberta) to conduct an observational cohort ‘trial emulation’ study with an active comparator and new-user design. Individuals with MS aged ≥18 years will be identified using a validated algorithm. Incident users of fingolimod and active comparators (natalizumab, alemtuzumab, dimethyl fumarate, teriflunomide) will then be identified. The outcome of interest will be skin cancer (melanoma and non-melanoma skin cancers). Survival analysis will be used to estimate HRs and corresponding 95% CIs, adjusted for potential confounders.Ethics and dissemination Ethics approval for this study was obtained from the University of British Columbia Clinical Research Ethics Board (H24-03199). No personal identifying information will be made available as part of this study. Findings will be disseminated through presentations and peer-reviewed publications.Trial registration number NCT06705608.
ISSN:2044-6055