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Tumour necrosis factor antagonist therapy and cancer development: analysis of the LORHEN registry

Francesca Bobbio Pallavicini1, Roberto Caporali, Piercarlo Sarzi-Puttini

  • 1Rheumatology Department, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy.

Autoimmunity Reviews
|August 4, 2009
PubMed
Abstract

Insights

Rheumatoid arthritis patients on anti-TNF therapy have similar overall cancer risk but a higher risk of lymphoma compared to the general population. Male gender and age over 65 increase cancer risk in this RA cohort.

Area of Science:

  • Rheumatology
  • Oncology
  • Immunology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
  • Tumor necrosis factor (TNF) antagonists are a common treatment for RA.
  • Cancer risk in RA patients treated with TNF antagonists requires careful evaluation.

Purpose of the Study:

  • To compare cancer risk in RA patients treated with TNF antagonists versus the general population.
  • To identify patient characteristics associated with increased cancer risk in this cohort.

Main Methods:

  • A cohort of 1114 RA patients treated with anti-TNF agents was observed.
  • Cancer incidence was compared to the general population using regional cancer registry data.
  • Univariate and multivariate analyses estimated relative cancer risks (hazard ratios).

Main Results:

  • Overall cancer risk was similar to the general population.
  • The risk of lymphoma was approximately five times higher in RA patients on anti-TNF therapy.
  • Increased cancer risk was associated with male gender and age >65 years; methotrexate combination therapy showed a protective effect.

Conclusions:

  • RA patients on anti-TNF therapy have a similar overall cancer risk but a significantly elevated risk of hematological cancers.
  • Male sex and age over 65 are risk factors for cancer in this population.
  • Further research into specific cancer risks and protective factors is warranted.

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