Risk of solid cancer in patients exposed to anti-tumour necrosis factor therapy: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis. Issue 6 (31st March 2014)

• Record Type: Journal Article
• Authors: Mercer, Louise K; Lunt, Mark; Low, Audrey L S; Dixon, William G; Watson, Kath D; Symmons, Deborah P M; Hyrich, Kimme L
• Other Names: Maiden Nicola author non-byline.; Price Tom author non-byline.; Hopkinson Neil author non-byline.; O'Reilly Sheila author non-byline.; Hordon Lesley author non-byline.; Griffiths Ian author non-byline.; Porter Duncan author non-byline.; Madhok R author non-byline.; Hassell Andy author non-byline.; Cooper R G author non-byline.; Choy Ernest author non-byline.; Walsh David author non-byline.; Emery Paul author non-byline.; Knight Susan author non-byline.; Bruce Ian author non-byline.; Taggart Allister author non-byline.; Scott David author non-byline.; Thompson Paul author non-byline.; McCrae Fiona author non-byline.; Goodfellow Rhian author non-byline.; Kitas George author non-byline.; Jubb Ronald author non-byline.; Abernethy Rikki author non-byline.; Green Sandra author non-byline.; Sanders Paul author non-byline.; Coulson Amanda author non-byline.; Harrison Bev author non-byline.; Bukhari Marwan author non-byline.; Klimiuk Peter author non-byline.
• Is Part Of: Annals of the rheumatic diseases. Volume 74:Issue 6(2015)
• Page Start: 1087
• Page End: 1093
• Publication Date: 2014-03-31
• Subjects: Rheumatoid Arthritis -- Anti-TNF -- Epidemiology; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2013-204851
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Patients with rheumatoid arthritis (RA) have an increased risk of certain solid cancers, in particular lung cancer, compared to the general population. Treatment with tumour necrosis factor (TNF) inhibitors (TNFi) may further enhance this risk. Objectives: To compare the risk of solid cancer in patients with RA treated with TNFi to that in patients treated with non-biologic (synthetic) disease modifying antirheumatic drugs (sDMARDs). Methods: Patients with a physician diagnosis of RA enrolled in the British Society for Rheumatology Biologics Register, a national prospective cohort study established in 2001 to monitor the long-term safety of TNFi, were followed via record linkage with the national cancer registries until first solid cancer, death, for 5 years, or until 2011. Rates of solid cancers in 11 767 patients without prior cancer who received TNFi were compared to those in 3249 patients without prior cancer treated with sDMARDs. Results: 427 solid cancers were reported in 52 549 patient-years follow-up for the TNFi group (81 (95% CI 74 to 89) per 10 000 patient-years) and 136 cancers were reported in 11 672 patient-years in the sDMARD cohort (117 (95% CI 98 to 138) per 10 000 patient-years). After adjusting for differences in baseline characteristics there was no difference in risk of solid cancer for TNFi compared to sDMARD treated patients: HR 0.83 (95% CI 0.64 to 1.07). There was no difference in the relative risk of cancer for any of the individual TNFi drugs. Conclusions: The addition of TNFi to sDMARD does not alter the risk of cancer in RA patients selected for TNFi in the UK.