Association between exposure to TNFi and lymphoma
| csDMARD N=3367 | TNFi N=11 931 | |
|---|---|---|
| Total follow-up time (pyrs) | 19 473 | 95 126 |
| Lymphomas | 30 | 84 |
| Incidence rate per 100 000 pyrs (95% CI) | 154 (104 to 220) | 88 (70 to 109) |
| Unadjusted HR (95% CI) | Referent | 0.61 (0.40 to 0.92) |
| Age-adjusted and sex-adjusted HR (95% CI) | Referent | 0.75 (0.49 to 1.15) |
| PD-adjusted HR (95% CI) | Referent | 1.00 (0.56 to 1.80) |
| On TNFi (plus 90 days)* | ||
| Follow-up time (pyrs) | 15 167 | 57 949 |
| Lymphomas | 25 | 63 |
| PD-adjusted HR (95% CI) | Referent | 1.17 (0.60 to 2.26) |
| Excluded time after switched to second biological drug* | ||
| Follow-up time (pyrs) | 15 167 | 55 167 |
| Lymphomas | 25 | 52 |
| PD-adjusted HR (95% CI) | Referent | 1.12 (0.58 to 2.18) |
| Cancer registry-only reported lymphomas | ||
| Follow-up time (pyrs) | 19 473 | 95 126 |
| Lymphomas | 27 | 76 |
| PD-adjusted HR (95% CI) | Referent | 1.02 (0.55 to 1.90) |
| Hodgkin's lymphomas (HL) | ||
| Incidence rate of HL per 100 000 pyrs (95% CI) | 26 (8 to 60) | 13 (7 to 22) |
| PD-adjusted HR for HL (95% CI) | Referent | 0.54 (0.12 to 2.50) |
| Non-Hodgkin's lymphomas (NHL) | ||
| Incidence rate of NHL per 100 000 pyrs (95% CI) | 128 (83 to 190) | 75 (58 to 94 |
| PD-adjusted HR for NHL (95% CI) | Referent | 1.10 (0.58 to 2.08) |
| DLBCL | ||
| Incidence rate of DLBCL per 100 000 pyrs (95% CI) | 67 (36 to 114) | 56 (42 to 73) |
| PD-adjusted HR for DLBCL (95% CI) | Referent | 1.54 (0.60 to 3.95) |
*Time after last received consultant follow-up form excluded from this analysis.
DLBCL, diffuse large B cell lymphoma; pyrs, patient-years; TNFi, tumour necrosis factor inhibitors.