Risk of overall cancer after treatment with TNF-I agents among patients with RA by adjustment for various measures of disease activity at enrolment, gender, time since initiation, cumulative duration of treatment and age at treatment start
| Variable | No of cancers among treated† | TNF-I treated versus non-treated HR‡ (95% CI) | p Value* |
|---|---|---|---|
| Ever TNF-I treatment | |||
| Overall effect | 152 | 1.02 (0.80 to 1.30) | |
| Plus adjustment for HAQ§ | 0.95 (0.74 to 1.22) | ||
| Plus adjustment for CRP§ | 0.99 (0.77 to 1.26) | ||
| Plus adjustment for DAS28§ | 0.96 (0.74 to 1.24) | ||
| Men | 48 | 0.83 (0.55 to 1.26) | p=0.24 |
| Women | 104 | 1.13 (0.83 to 1.53) | |
| Time since treatment initiation, years | |||
| <1 | 41 | 1.04 (0.72 to 1.50) | |
| 1–4 | 97 | 1.03 (0.79 to 1.35) | p=0.86 |
| 5+ | 14 | 0.88 (0.51 to 1.54) | |
| 1+ | 111 | 1.01 (0.78 to 1.30) | |
| Cumulative duration of treatment, years | |||
| <1 | 43 | 1.04 (0.73 to 1.48) | |
| 1–2 | 39 | 1.19 (0.83 to 1.71) | p=0.69 |
| 2–3 | 29 | 1.09 (0.72 to 1.63) | |
| 4+ | 41 | 0.86 (0.60 to 1.22) | |
| Age at treatment start, years | |||
| <50 | 12 | 0.83 (0.38 to 1.82) | |
| 50–64 | 69 | 0.97 (0.68 to 1.37) | p=0.76 |
| ≥65 | 71 | 1.10 (0.80 to 1.50) | |
*p Values for homogeneity test based on Wald statistics.
†There were 128 cancer cases observed among non-tumour necrosis factor α inhibitor (TNF-I)-treated patients.
‡HR ratios estimated using Cox proportional hazard models with age as the underlying time scale and with further adjustment for sex and calendar time (2000–4, 2005–8).
§Adjustment for high disease activity at first visit (health assessment questionnaire (HAQ) ≥2; C-reactive protein (CRP) ≥30 mg/l; disease activity score in 28 joints (DAS28) ≥5.1). Similar results were found after adjustment for the same disease activity measures at the latest visit or at any time.
RA, rheumatoid arthritis.