Risk factors of lymphoma for patients receiving anti-TNF agents (univariate analysis: main analysis and analysis restricted to RA patients)
| All lymphoma (37 cases and 74 controls) | Lymphoma in RA patients (27 cases and 54 controls) | |||||||
| Cases (n = 37) | Controls (n = 74) | OR (95% CI) | p Value | Cases (n = 27) | Controls (n = 54) | OR (95% CI) | p Value | |
| Duration of the underlying inflammatory disease, years | 11.07 (8.75) | 16.5 (SD 12.4) | 0.95 (0.91 to 1.00) | 0.047 | 11.26 (8.97) | 17.46 (12.12) | 0.94 (0.88 to 1.00) | 0.06 |
| Activity of the underlying inflammatory disease at the time of diagnosis of lymphoma | ||||||||
| Null, fair, or moderate | 23 (69.7%) | 42 (85.7%) | 1 | 0.22 | 17 (70.8%) | 33 (89.2%) | 1 | 0.15 |
| High | 10 (30.3%) | 7 (14.3%) | 2.04 (0.65 to 6.44) | 7 (29.2%) | 4 (10.8%) | 2.84 (0.69 to 11.67) | ||
| No of anti-TNF agents received | ||||||||
| 1 | 30 (81.1%) | 56 (75.7%) | 1 | 0.51 | 20 (74.1%) | 40 (74.1%) | 1 | 1.00 |
| 2 or 3 | 7 (18.9%) | 18 (24.3%) | 0.71 (0.25 to 1.97) | 7 (25.9%) | 14 (25.9%) | 1.00 (0.33 to 3.04) | ||
| First anti-TNF agent received | ||||||||
| Etanercept | 11 (29.7%) | 30 (40.5%) | 1 | |||||
| Adalimumab | 8 (21.6%) | 9 (12.2%) | 2.64 (0.74 to 9.41) | 0.33 | ||||
| Infliximab | 18 (48.6%) | 35 (47.3%) | 1.38 (0.55 to 3.45) | |||||
| First anti-TNF agent received | ||||||||
| Etanercept | 11 (29.7%) | 30 (40.5%) | 1 | 8 (29.6%) | 26 (48.1%) | 1 | ||
| Adalimumab or infliximab | 26 (70.3%) | 44 (59.5%) | 1.61 (0.69 to 3.78) | 0.27 | 19 (70.4%) | 28 (51.9%) | 2.05 (0.79 to 5.27) | 0.14 |
| Last anti-TNF agent received | ||||||||
| Etanercept | 7 (18.9%) | 33 (44.6%) | 1 | |||||
| Adalimumab | 12 (32.4%) | 13 (17.6%) | 4.52 (1.39 to 14.71) | 0.03 | ||||
| Infliximab | 18 (48.6%) | 28 (37.8%) | 3.00 (1.10 to 8.15) | |||||
| Last anti-TNF agent received | ||||||||
| Etanercept | 7 (18.9%) | 33 (44.6%) | 1 | 4 (14.8%) | 29 (53.7%) | 1 | ||
| Adalimumab or infliximab | 30 (81.1%) | 41 (55.4%) | 3.40 (1.31 to 8.80) | 0.012 | 23 (85.2%) | 25 (46.3%) | 6.68 (1.90 to 23.54) | 0.003 |
| Time from onset of first anti-TNF treatment† | ||||||||
| <2 years | 20 (54.1%) | 24 (32.4%) | 2.71 (1.09 to 6.73) | 0.03 | 14 (51.9%) | 38 (70.4%) | 2.46 (0.83 to 7.26) | 0.10 |
| ⩾2 years | 17 (45.9%) | 50 (67.6%) | 1 (Ref) | 13 (48.1%) | 16 (29.6%) | 1 (Ref) | ||
| Time from onset of last anti-TNF treatment† | ||||||||
| <2 years | 23 (62.2%) | 31 (41.9%) | 2.37 (1.00 to 5.60) | 0.05 | 16 (59.3%) | 23 (42.6%) | 2.05 (0.75 to 5.61) | 0.16 |
| ⩾2 years | 14 (37.8%) | 43 (58.1%) | 1 (Ref) | 11 (40.7%) | 31 (57.4%) | 1 (Ref) | ||
| Year of onset of first anti-TNF agent use before 2002 | ||||||||
| No | 29 (78.4%) | 61 (82.4%) | 1 | 0.60 | 21 (77.8%) | 42 (77.8%) | 1 | 1.00 |
| Yes | 8 (21.6%) | 13 (17.6%) | 1.32 (0.47 to 3.69) | 6 (22.2%) | 12 (22.2%) | 1.00 (0.32 to 3.17) | ||
| Etanercept use | ||||||||
| Never | 24 (64.9%) | 35 (47.3%) | 1 | 0.08 | 17 (63.0%) | 20 (37.0%) | 1 | 0.04 |
| Ever | 13 (35.1%) | 39 (52.7%) | 0.45 (0.19 to 1.09) | 10 (37.0%) | 34 (63.0%) | 0.35 (0.13 to 0.94) | ||
| Infliximab or adalimumab use | ||||||||
| Never | 6 (16.2%) | 24 (32.4%) | 1 | 3 (11.1%) | 21 (38.9%) | 1 | ||
| Ever | 31 (83.8%) | 50 (67.6%) | 2.36 (0.89 to 6.27) | 0.08 | 24 (88.9%) | 33 (61.1%) | 4.59 (1.27 to 16.56) | 0.02 |
| Methotrexate‡ | ||||||||
| No | 11 (29.7%) | 18 (24.3%) | 1 | 0.52 | 4 (14.8%) | 11 (20.4%) | 1 | 0.54 |
| Yes | 26 (70.3%) | 56 (75.7%) | 0.73 (0.29 to 1.87) | 23 (85.2%) | 43 (79.6%) | 1.50 (0.41 to 5.54) | ||
| Azathioprine‡ | ||||||||
| No | 34 (91.9%) | 66 (89.2%) | 1 | 0.49 | 27 (100.0%) | 51 (94.4%) | 1 | |
| Yes | 3 (8.1%) | 8 (10.8%) | 0.43 (0.04 to 4.61) | 0 (0.0%) | 3 (5.6%) | – | – | |
| Leflunomide‡ | ||||||||
| No | 30 (81.1%) | 58 (78.4%) | 1 | 0.73 | 20 (74.1%) | 38 (70.4%) | 1 | 0.73 |
| Yes | 7 (18.9%) | 16 (21.6%) | 0.83 (0.30 to 2.34) | 7 (25.9%) | 16 (29.6%) | 0.83 (0.30 to 2.34) | ||
Continuous variables are mean (SD). Categorised variables are numbers (%). OR, odds ratio; RA, rheumatoid arthritis. †Time from onset of the last anti-TNF treatment and first symptoms of lymphoma for cases, time from onset of the last anti-TNF treatment and last news for controls. ‡Treatment during the last 5 years.