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Cancer research

Cancer Risk in Patients with Rheumatoid Arthritis Treated with Anti-Tumor Necrosis Factor Alpha Therapies

Strategic Insights

— 2 min read

Scientists in Stockholm, Sweden, have published a report examining the short-term and medium-term risks of cancer in patients receiving anti-tumor necrosis factor alpha (anti-TNF-alpha) therapies for chronic inflammatory conditions. The study, which linked data from the Swedish Biologics Register, Swedish registers of RA, and the Swedish Cancer Register, identified a national cohort of 6,366 patients with RA who started anti-TNF therapy between January 1999 and July 2006. The researchers found no overall elevation of cancer risk and no increase with follow-up time during the first 6 years after the start of anti-TNF therapy in routine care.

Key Takeaways:

  • The study examined the cancer risk in 6,366 patients with rheumatoid arthritis (RA) who started anti-tumor necrosis factor alpha (anti-TNF-alpha) therapies between January 1999 and July 2006.
  • The patients were compared to a national biologics-naive RA cohort, a cohort of RA patients newly starting methotrexate, a cohort of RA patients newly starting disease-modifying antirheumatic drug combination therapy, and the general population of Sweden.
  • Relative risks (RRs) were estimated using Cox regression analyses, examining overall RR as well as RR by time since the first start of anti-TNF therapy, by the duration of active anti-TNF therapy, and by the anti-TNF agent received.
  • During 25,693 person-years of follow-up, 240 first cancers occurred, yielding an RR of 1.00 (95% confidence interval 0.86-1.15) versus the biologics-naive RA cohort.
  • The researchers observed no increase in cancer risk with increasing time since the start of anti-TNF therapy, nor with the cumulative duration of active anti-TNF therapy.
  • During the first year following the first treatment start, but not thereafter, dissimilar cancer risks for adalimumab, etanercept, and infliximab were observed.
  • The study concluded that during the first 6 years after the start of anti-TNF therapy in routine care, no overall elevation of cancer risk and no increase with follow-up time were observed.

Statistics:

  • 6,366 patients with RA who started anti-TNF therapy between January 1999 and July 2006
  • 25,693 person-years of follow-up
  • 240 first cancers occurred
  • RR of 1.00 (95% confidence interval 0.86-1.15) versus the biologics-naive RA cohort
  • No increase in cancer risk with increasing time since the start of anti-TNF therapy
  • No increase in cancer risk with the cumulative duration of active anti-TNF therapy

Sources:

  • Askling, J., et al. (2009). Cancer risk in patients with rheumatoid arthritis treated with anti-tumor necrosis factor alpha therapies: does the risk change with the time since start of treatment? Arthritis and Rheumatism, 60(11), 3180-9.
  • Wiley-Liss, Division John Wiley & Sons Inc., 111 River St., Hoboken, NJ 07030, USA (publisher's contact information for the journal Arthritis and Rheumatism)

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