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Tumour necrosis factor blockers do not increase overall tumour risk in patients with rheumatoid arthritis, but may be associated with an increased risk of lymphomas

Geborek, Pierre LU ; Bladström, Anna LU ; Turesson, Carl LU ; Gülfe, Anders LU ; Petersson, I F; Saxne, Tore LU ; Olsson, Håkan LU and Jacobsson, Lennart LU (2005) In Annals of the Rheumatic Diseases 64(5). p.699-703
Abstract
Objective: To determine whether TNF blockers increase tumour risk in patients with RA. Material and methods: The South Swedish Arthritis Treatment Group register (SSATG) comprises over 90% of anti-TNF treated patients with RA in the area. 757 patients treated with etanercept or infliximab included between 1 February 1999 and 31 December 2002 were identified. 800 patients with conventional antirheumatic treatment in a community based cohort served as a comparison cohort. Tumours and deaths were identified in the cancer registry and population census registers. Patients were followed up from initiation of anti-TNF treatment or 1 July 1997 for the comparison group, until death or 31 December 2002. Results: In the anti-TNF group, 16 tumours (... (More)
Objective: To determine whether TNF blockers increase tumour risk in patients with RA. Material and methods: The South Swedish Arthritis Treatment Group register (SSATG) comprises over 90% of anti-TNF treated patients with RA in the area. 757 patients treated with etanercept or infliximab included between 1 February 1999 and 31 December 2002 were identified. 800 patients with conventional antirheumatic treatment in a community based cohort served as a comparison cohort. Tumours and deaths were identified in the cancer registry and population census registers. Patients were followed up from initiation of anti-TNF treatment or 1 July 1997 for the comparison group, until death or 31 December 2002. Results: In the anti-TNF group, 16 tumours ( 5 lymphomas) were identified in 1603 person-years at risk, and in the comparison group 69 tumours ( 2 lymphomas) in 3948 person-years. Standardised incidence ratios (SIRs) for total tumour relative risk for the anti-TNF group and the comparison group were 1.1 (95% confidence interval (CI) 0.6 to 1.8) and 1.4 ( 95% CI 1.1 to 1.8), respectively. The lymphoma relative risk (RR) was 11.5 ( 95% CI 3.7 to 26.9) and 1.3 ( 95% CI 0.2 to 4.5), respectively The total tumour RR excluding lymphoma was 0.79 ( 95% CI 0.4 to 1.42) and 1.39 ( 95% CI 1.08 to 1.76), respectively. Proportional hazard analysis for lymphomas yielded RR 4.9 ( 95% CI 0.9 to 26.2) in anti-TNF treated versus untreated patients. Conclusion: Community based patients with RA treated conventionally had an increased overall tumour risk compared with the background population. A possible additional increased risk for lymphoma associated with TNF blockers was based on few cases and needs confirmation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
64
issue
5
pages
699 - 703
publisher
British Medical Association
external identifiers
  • wos:000228444500008
  • pmid:15695534
  • scopus:17644374819
ISSN
1468-2060
DOI
10.1136/ard.2004.030528
language
English
LU publication?
yes
id
1d746e88-71e8-49c8-8ed0-0d0109d21865 (old id 245903)
date added to LUP
2007-09-21 16:51:02
date last changed
2017-11-05 04:32:45
@article{1d746e88-71e8-49c8-8ed0-0d0109d21865,
  abstract     = {Objective: To determine whether TNF blockers increase tumour risk in patients with RA. Material and methods: The South Swedish Arthritis Treatment Group register (SSATG) comprises over 90% of anti-TNF treated patients with RA in the area. 757 patients treated with etanercept or infliximab included between 1 February 1999 and 31 December 2002 were identified. 800 patients with conventional antirheumatic treatment in a community based cohort served as a comparison cohort. Tumours and deaths were identified in the cancer registry and population census registers. Patients were followed up from initiation of anti-TNF treatment or 1 July 1997 for the comparison group, until death or 31 December 2002. Results: In the anti-TNF group, 16 tumours ( 5 lymphomas) were identified in 1603 person-years at risk, and in the comparison group 69 tumours ( 2 lymphomas) in 3948 person-years. Standardised incidence ratios (SIRs) for total tumour relative risk for the anti-TNF group and the comparison group were 1.1 (95% confidence interval (CI) 0.6 to 1.8) and 1.4 ( 95% CI 1.1 to 1.8), respectively. The lymphoma relative risk (RR) was 11.5 ( 95% CI 3.7 to 26.9) and 1.3 ( 95% CI 0.2 to 4.5), respectively The total tumour RR excluding lymphoma was 0.79 ( 95% CI 0.4 to 1.42) and 1.39 ( 95% CI 1.08 to 1.76), respectively. Proportional hazard analysis for lymphomas yielded RR 4.9 ( 95% CI 0.9 to 26.2) in anti-TNF treated versus untreated patients. Conclusion: Community based patients with RA treated conventionally had an increased overall tumour risk compared with the background population. A possible additional increased risk for lymphoma associated with TNF blockers was based on few cases and needs confirmation.},
  author       = {Geborek, Pierre and Bladström, Anna and Turesson, Carl and Gülfe, Anders and Petersson, I F and Saxne, Tore and Olsson, Håkan and Jacobsson, Lennart},
  issn         = {1468-2060},
  language     = {eng},
  number       = {5},
  pages        = {699--703},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Tumour necrosis factor blockers do not increase overall tumour risk in patients with rheumatoid arthritis, but may be associated with an increased risk of lymphomas},
  url          = {http://dx.doi.org/10.1136/ard.2004.030528},
  volume       = {64},
  year         = {2005},
}