Table 2

Malignancies in patients on bDMARDs compared with patients on csDMARDs (observational studies)

Study IDRegistryInterventionControlaHR (I vs C)Risk of bias
All types of cancer
Wadstrom 2017
JAMA Intern Med31
ARTISTCZcsDMARDs0.9 (0.7; 1.2)Low
ABA0.9 (0.7; 1.1)
RTX0.9 (0.7; 1.0)
TNFi0.9 (0.9; 1.0)
Patients with history of cancer
Silva-Fernández 2016
Rheumatology (Oxford)30
BSRBR-RATNFicsDMARDs 0.6 (0.4; 0.9)Low
RTX0.4 (0.1; 1.8)
Solid cancer (excluding NMSC)
Wadström 2017
JAMA Intern Med31
ARTISTCZcsDMARDs1.0 (0.7; 1.3)Low
ABA0.9 (0.7; 1.2)
RTX0.9 (0.8; 1.1)
TNFi0.9 (0.9; 1.0)
Non-melanoma skin cancer
Wadström 2017
JAMA Intern Med31
ARTISTCZcsDMARDs0.9 (0.4; 2.2)Low
ABA 2.2 (1.3; 3.5)
RTX1.0 (0.7; 1.6)
TNFi1.1 (0.8; 1.4)
Melanoma
Wadström 2017
JAMA Intern Med31
ARTISTCZcsDMARD<5 eventsLow
ABA1.4 (0.7; 3.1)
RTX0.7 (0.4; 1.4)
TNFi0.8 (0.6; 1.2)
Cervical cancer
Kim 2016
Arthritis Rheumatol26
Claims databasebDMARDscsDMARDs1.3 (0.9; 2.0)High
Wadström 2016
Ann Rheum Dis32
ARTISTNFicsDMARDs1.4 (0.6; 3.1)Low
Haematological cancer
Wadstrom 2017
JAMA Intern Med31
ARTISTCZcsDMARDs<5 eventsLow
ABA1.0 (0.5; 2.0)
RTX0.7 (0.5; 1.2)
TNFi0.9 (0.7; 1.1)
Lymphoma
Mercer 2017
Ann Rheum Dis29
BSRBR-RAIFXcsDMARDs0.9 (0.4; 2.1)Low
ETA1.0 (0.5; 2.3)
ADA1.0 (0.5; 2.0)
All TNFi1.0 (0.6; 1.8)
  • Additional details in online supplementary tables S32–59.

  • ABA, abatacept; ADA, adalimumab; aHR, adjusted HR; ARSTIS, anti-Rheumatic Treatment in Sweden Register; bDMARDs, biologic disease-modifying antirheumatic drugs; BSRBR, British Society of Rheumatology Biologics Register; csDMARDs, conventional synthetic disease-modifying antirheumatic drugs; ETA, etanercept; IFX, infliximab; RA, rheumatoid arthritis; RTX, rituximab; TCZ, tocilizumab; TNFi, tumour necrosis factor inhibitor; TOFA, tofacitinib.