Format

Send to

Choose Destination
Semin Arthritis Rheum. 2011 Aug;41(1):71-80. doi: 10.1016/j.semarthrit.2010.08.005. Epub 2010 Nov 18.

Cancer in patients with rheumatic diseases exposed to TNF antagonists.

Collaborators (98)

Sellas A, Rodríguez B, Barceló M, Cebrián L, Montoro M, Montesinos D, Pérez-Pampín E, Ortiz AM, Tomero E, Antón F, Zea A, Manero Ruiz FJ, Beltrán C, Gimenez Úbeda E, Jimenez Zorzo F, Marzo J, Medrano M, Pecondón Á, Hernández MV, Sanmartí R, Cañete JD, Rodriguez Lozano C, Naranjo A, Ojeda S, Francisco Hernández F, Erausquin C, Rúa Í, Ureña I, Irigoyen MV, Cano L, Pardo RR, Galeano CV, de Juanes A, Joven B, Garcia J, Calvo J, Campos C, Borras JJ, Negueroles R, Muñoz L, Valero JL, Ybañez D, Abasolo AL, de Alegre MC, Andreu Sánchez JL, Aragón Díez A, Balsa Criado A, Batlle Gualda E, Belmonte Serrano MA, Beltrán Audera J, Beltrán Fabregat J, Bonilla Hernan G, Carmona Ortells L, Caro Fernández N, Casado E, Cebrian Mendez L, Corteguera Coro M, Cuadra Díaz JL, Cuesta E, Fiter Aresté J, Freire Gonzalez M, Galindo Izquierdo M, García Meijide JA, García Gómez MC, Giménez Ubeda E, Gómez Centeno E, Gómez Vaquero C, González Fernández MJ, González Gómez ML, González Hernández T, González-Alvaro I, González-Montagut Gómez C, Grandal Delgado Y, Gratacos Masmitja J, Hernández del Río A, Instxaurbe AR, Irigoyen Oyarzabal MV, Jiménez Palop M, Juan Mas A, Judez Navarro E, Larrosa Padro M, López Longo FJ, Loza Santamaria E, Maese Manzano J, Manero Ruiz FJ, Mateo Bernardo I, Mayordomo González L, Mazzucheli R, Medrano San Idelfonso M, Naranjo Hernández A, Pecondón Español A, Peiró Callizo E, Quirós Donate J, Ramos López P, Rivera Redondo J, Rodríguez Gómez M, Rodríguez López M, Roselló Pardo R.

Author information

1
Research Unit, Sociedad Española de Reumatología, Madrid, Spain. loreto.carmona@ser.es

Abstract

OBJECTIVE:

To describe the risk of cancer in patients exposed to tumor necrosis factor (TNF) antagonists.

METHODS:

The following 2 clinical cohorts were studied: (1) BIOBADASER 2.0: a registry of patients suffering from rheumatic diseases exposed to TNF antagonists (2531 rheumatoid arthritis (RA), 1488 spondyloarthropathies, and 675 other rheumatic conditions); and (2) EMECAR: a cohort of 789 RA patients not exposed to TNF antagonists. Cancer incidence rates (IR) per 1000 patient-years and incidence rate ratios (IRR) were calculated for BIOBADASER 2.0 and EMECAR patients. The IR over time in BIOBADASER 2.0 patients was analyzed by joinpoint regression. The IRR was estimated to compare cancer rates in exposed versus nonexposed RA patients. Standardized incidence and mortality ratios (SIR, SMR) were also estimated. Risk factors for cancer in patients exposed to TNF antagonists were investigated by generalized linear models.

RESULTS:

The SMR for cancer in BIODASER 2.0 was 0.67 (95% CI: 0.51-0.86), and the SIR was 0.1 (95% CI 0.03-0.23). The IR in RA patients exposed to TNF antagonists was 5.8 (95% CI: 4.4-7.6), and the adjusted IRR was 0.48 (95% CI: 0.09-2.45). The IR in patients with previous cancer was 26.4 (95% CI: 4.1-171.5). Age, chronic obstructive pulmonary disease, and steroids were associated with a higher risk of developing cancer. The IR decreased after the first 4 months of exposure, without statistical significance.

CONCLUSION:

Overall cancer and mortality rates in patients with rheumatic diseases exposed to TNF antagonists are no higher than in the background Spanish population. However special attention should be paid to elderly patients, those with previous cancers, and patients treated with steroids.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center