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Correspondence response
Response to: ‘Does the risk of lymphoma in patients with RA treated with TNF inhibitors differ according to the histological subtype and the type of TNF inhibitor?’ by Nocturne et al
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  1. Louise K Mercer1,
  2. James B Galloway2,
  3. Mark Lunt1,
  4. Rebecca Davies1,
  5. Audrey AL Low1,
  6. Will G Dixon1,2,
  7. Kath D Watson1,
  8. Deborah PM Symmons1,2,
  9. Kimme L Hyrich1,2
  1. 1Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester, UK
  2. 2King's College London, London, UK
  1. Correspondence to Professor Kimme L Hyrich, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK; kimme.hyrich{at}manchester.ac.uk

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We thank Nocturne et al1 for their interest and comments on our recent paper, which looked at lymphoma risk over the medium term in a cohort of patients receiving tumour necrosis factor inhibitor (TNFi).1 Overall we found no statistically significant difference in the risk compared with conventional standard disease-modifying antirheumatic drugs (csDMARDs) either for all TNFi exposures combined or when each TNFi was analysed separately in comparison to csDMARDs, using a number of different models to categorise treatment exposure.

We agree that lymphoma is a heterogeneous group of malignancies and that the spectrum of lymphomas seen in people with rheumatoid arthritis (RA) is different from that in the general population, with an over-representation of inflammation-driven diffuse large B-cell lymphoma (DLBCL). Therefore, understanding whether TNFi treatment is associated with an increase in the risk …

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