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Incidences of overall and site specific cancers in TNFα inhibitor treated patients with rheumatoid arthritis and other arthritides – a follow-up study from the DANBIO Registry
  1. Lene Dreyer1,
  2. Lene Mellemkjær2,
  3. Anne Rødgaard Andersen3,
  4. Philip Bennett4,
  5. Uta Engling Poulsen5,
  6. Torkell Juulsgaard Ellingsen6,
  7. Torben Høiland Hansen7,
  8. Dorte Vendelbo Jensen8,
  9. Louise Linde3,
  10. Hanne Merete Lindegaard9,
  11. Anne Gitte Rasmussen Loft10,
  12. Henrik Nordin11,
  13. Emina Omerovic12,
  14. Claus Rasmussen13,
  15. Annette Schlemmer14,
  16. Ulrik Tarp15,
  17. Merete Lund Hetland3,16
  1. 1Department of Rheumatology, Gentofte University Hospital, Hellerup, Denmark
  2. 2Danish Cancer Society Research Center, Copenhagen, Denmark
  3. 3DANBIO Registry and Department of Rheumatology, Glostrup University Hospital, Glostrup, Denmark
  4. 4Department of Rheumatology, Frederiksberg University Hospital, Frederiksberg, Denmark
  5. 5Department of Rheumatology, Rheumatism Hospital, University of Southern Denmark, Graasten, Denmark
  6. 6Rheumatology Unit, Diagnostic Center, Region Hospital Silkeborg, Silkeborg, Denmark
  7. 7Department of Rheumatology, Holbæk University Hospital, Holbæk, Denmark
  8. 8Department of Rheumatology, Helsingør Hospital, Helsingør, Denmark
  9. 9Department of Rheumatology, Odense University Hospital, Odense, Denmark
  10. 10Department of Rheumatology, Vejle Hospital, Hospital Lillebælt, Vejle, Denmark
  11. 11Department of Infectious Diseases and Rheumatology, Rigshospitalet Universtity Hospital, Copenhagen, Denmark
  12. 12Department of Rheumatology, Køge Hospital, Køge, Denmark
  13. 13Department of Rheumatology, Vendsyssel Hospital, Hjørring, Denmark
  14. 14Department of Rheumatolgy, Aalborg University Hospital, Aalborg, Denmark
  15. 15Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
  16. 16On behalf of all departments of Rheumatology in Denmark
  1. Correspondence to Dr Lene Dreyer, Department of Rheumatology, Gentofte University Hospital, Niels Andersens Vej 65, 2900 Hellerup, Denmark; lene.dreyer{at}dadlnet.dk

Abstract

Objectives To investigate the incidence of cancer in arthritis patients treated with or without TNFα inhibitors (TNF-I).

Methods Arthritis patients from the DANBIO database were followed-up for cancer in the Danish Cancer Registry during 2000–2008.

Results Hazard ratio for cancer overall was 1.02 (95% confidence interval (CI) 0.80-1.30) in 3347 TNF-I-treated RA patients compared to non-treated. Excess among TNF-I-treated was found for colon cancer (HR 3.52 (95%CI 1.11-11.15), whereas 6 and 0 ovarian cancer cases were observed in treated and non-treated patients, respectively. Compared to the general population, TNF-I-treated RA patients had increased risk for cancer overall, cancer in lymphatic-haematopoietic tissue and non-melanoma skin cancer, while non-RA patients had no increase in overall cancer risk.

Conclusions Our results suggest that TNF-I therapy in routine care is not associated with an overall excess of cancer in arthritis patients, but observed increased risks of colon and ovarian cancer need further investigation.

  • Anti-TNF
  • Treatment
  • Epidemiology
  • DMARDs (biologic)
  • Rheumatoid Arthritis

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