Document Detail

Tumor necrosis factor α inhibitor therapy and cancer risk in chronic immune-mediated diseases.
MedLine Citation:
PMID:  23055441     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare the incidence of cancer following tumor necrosis factor α (TNFα) inhibitor therapy to that with commonly used alternative therapies across multiple immune-mediated diseases.
METHODS: The Safety Assessment of Biological Therapeutics study used data from 4 sources: national Medicaid and Medicare databases, Tennessee Medicaid, pharmacy benefits plans for Medicare beneficiaries in New Jersey and Pennsylvania, and Kaiser Permanente Northern California. Propensity score-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) were computed to estimate the relative rates of cancer, comparing those treated with TNFα inhibitors to those treated with alternative disease-modifying therapies. The cancer-finding algorithm had a positive predictive value ranging from 31% for any leukemia to 89% for female breast cancer.
RESULTS: We included 29,555 patients with rheumatoid arthritis (RA) (13,102 person-years), 6,357 patients with inflammatory bowel disease (1,508 person-years), 1,298 patients with psoriasis (371 person-years), and 2,498 patients with psoriatic arthritis (618 person-years). The incidence of any solid cancer was not elevated in RA (HR 0.80 [95% CI 0.59-1.08]), inflammatory bowel disease (HR 1.42 [95% CI 0.47-4.26]), psoriasis (HR 0.58 [95% CI 0.10-3.31]), or psoriatic arthritis (HR 0.74 [95% CI 0.20-2.76]) during TNFα inhibitor therapy compared to disease-specific alternative therapy. Among RA patients, the incidence of any of the 10 most common cancers in the US and of nonmelanoma skin cancer was not increased with TNFα inhibitor therapy compared to treatment with comparator drugs.
CONCLUSION: Short-term cancer risk was not elevated among patients treated with TNFα inhibitor therapy relative to commonly used therapies for immune- mediated chronic inflammatory diseases in this study.
Kevin Haynes; Timothy Beukelman; Jeffrey R Curtis; Craig Newcomb; Lisa J Herrinton; David J Graham; Daniel H Solomon; Marie R Griffin; Lang Chen; Liyan Liu; Kenneth G Saag; James D Lewis;
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  65     ISSN:  1529-0131     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-02     Completed Date:  2013-03-17     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  48-58     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 by the American College of Rheumatology.
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MeSH Terms
Antibodies, Monoclonal / adverse effects*,  therapeutic use
Chronic Disease
Cohort Studies
Follow-Up Studies
Immune System Diseases / drug therapy*
Immunologic Factors / adverse effects*,  therapeutic use
Middle Aged
Neoplasms / epidemiology*,  immunology
Retrospective Studies
Risk Factors
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Grant Support
1U18-HS-017919-0/HS/AHRQ HHS; 5KL2-RR-025776/RR/NCRR NIH HHS; AR-053351/AR/NIAMS NIH HHS; K23 AR053351/AR/NIAMS NIH HHS; K24 DK078228/DK/NIDDK NIH HHS; K24-DK07822806/DK/NIDDK NIH HHS; KL2 RR025776/RR/NCRR NIH HHS; R01 HS018517/HS/AHRQ HHS; R01-HS-018517/HS/AHRQ HHS
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunologic Factors; 0/Tumor Necrosis Factor-alpha
Parivash Nourjah / ; Robert Glynn / ; Mary Kowal / ; Joyce Lii / ; Jeremy Rassen / ; Sebastian Schneeweiss / ; Rita Ouellet-Hellstrom / ; Jane Gilbert / ; Carolyn McCloskey / ; Kristin Phucas / ; James William / ; Leslie Harrold / ; Marcia Raebel / ; Carlos Grijalva / ; Ed Mitchel /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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