Clinical Edge Journal Scan

No evidence of increased cancer incidence with long-term TNFi use in RA


 

Key clinical point: Long-term use of tumor necrosis factor inhibitors (TNFis) for rheumatoid arthritis (RA) in clinical practice was not associated with an increased incidence of overall cancer. However, a higher risk of developing urinary tract cancer was observed for TNFi, rituximab, and abatacept.

Major finding: Compared with biologic and targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-naive patients, the relative risk for overall cancer was not higher among those treated with TNFis for 10 or more years (adjusted hazard ratio [aHR], 1.0; 95% confidence interval [CI], 0.8-1.2). However, the risk for urinary tract cancer was significantly higher with TNFi (aHR, 1.5; 95% CI, 1.1-1.9), rituximab (aHR, 2.1; 95% CI, 1.3-3.7), and abatacept (aHR, 2.3; 95% CI, 1.3-3.9).

Study details: This was an observational cohort study that included patients with RA (n=69,308) who received TNFis or other b/tsDMARDs, b/tsDMARDs-naïve patients with RA (n=56,233), and matched general population referents (n=109,532).

Disclosures: This study was funded by the Karolinska Institute Region Stockholm. J Askling declared research agreements with various sources. The other authors declared no conflict of interests.

Source: Huss V et al. Rheumatology (Oxford). 2021 Jul 29. doi: 10.1093/rheumatology/keab570 .

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