Table 3

Association between exposure to TNFi and lymphoma

csDMARD
N=3367
TNFi
N=11 931
Total follow-up time (pyrs)19 47395 126
Lymphomas3084
Incidence rate per 100 000 pyrs (95% CI)154 (104 to 220)88 (70 to 109)
Unadjusted HR (95% CI)Referent0.61 (0.40 to 0.92)
Age-adjusted and sex-adjusted HR (95% CI)Referent0.75 (0.49 to 1.15)
PD-adjusted HR (95% CI)Referent1.00 (0.56 to 1.80)
On TNFi (plus 90 days)*
 Follow-up time (pyrs)15 16757 949
 Lymphomas2563
 PD-adjusted HR (95% CI)Referent1.17 (0.60 to 2.26)
Excluded time after switched to second biological drug*
 Follow-up time (pyrs)15 16755 167
 Lymphomas2552
 PD-adjusted HR (95% CI)Referent1.12 (0.58 to 2.18)
Cancer registry-only reported lymphomas
 Follow-up time (pyrs)19 47395 126
 Lymphomas2776
 PD-adjusted HR (95% CI)Referent1.02 (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)Referent0.54 (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)Referent1.10 (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)Referent1.54 (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.