Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors : a Nordic cohort study
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: To evaluate the risk of haematological malignancies in patients with psoriatic arthritis (PsA) overall, and in relation to treatment with tumour necrosis factor inhibitors (TNFi).
METHODS: We identified that patients with PsA starting a first TNFi from the clinical rheumatology registers (CRR) in the five Nordic countries (n=10 621) and biologics-naïve PsA patients from (1) the CRR (n=18 705) and (2) the national patient registers (NPR, n=27 286, Sweden and Denmark) from 2006 through 2019. For Sweden and Denmark, general population comparators were matched 5:1 to PsA patients on birth year, year at start of follow-up and sex. By linkage to the national cancer registers in all countries, we collected information on haematological malignancies overall, and categorised into lymphoid or myeloid types. We estimated incidence rate ratios (IRRs) with 95% CIs using modified Poisson regression for TNFi-treated versus biologics-naïve PsA patients and versus the general population adjusted for age, sex, calendar period and country.
RESULTS: During 59 827 person-years, 40 haematological malignancies occurred among TNFi-treated patients with PsA resulting in a pooled IRR of 0.96 (0.68-1.35) versus biologics-naïve PsA from CRR and an IRR of 0.84 (0.64-1.10) versus biologics-naïve PsA from NPR. The IRR of haematological malignancies in PsA overall versus general population comparators was 1.35 (1.17-1.55). The estimates were largely similar for lymphoid and myeloid malignancies.
CONCLUSIONS: Treatment with TNFi in patients with PsA was not associated with an increased incidence of haematological malignancies. Conversely, a moderately increased underlying risk was seen in patients with PsA compared with the general population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
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| Enthalten in: |
RMD open - 8(2022), 2 vom: 03. Dez. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cordtz, Rene Lindholm [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 27.12.2022 Date Revised 09.01.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1136/rmdopen-2022-002776 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM350756120 |
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| 100 | 1 | |a Cordtz, Rene Lindholm |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors |b a Nordic cohort study |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 09.01.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVES: To evaluate the risk of haematological malignancies in patients with psoriatic arthritis (PsA) overall, and in relation to treatment with tumour necrosis factor inhibitors (TNFi) | ||
| 520 | |a METHODS: We identified that patients with PsA starting a first TNFi from the clinical rheumatology registers (CRR) in the five Nordic countries (n=10 621) and biologics-naïve PsA patients from (1) the CRR (n=18 705) and (2) the national patient registers (NPR, n=27 286, Sweden and Denmark) from 2006 through 2019. For Sweden and Denmark, general population comparators were matched 5:1 to PsA patients on birth year, year at start of follow-up and sex. By linkage to the national cancer registers in all countries, we collected information on haematological malignancies overall, and categorised into lymphoid or myeloid types. We estimated incidence rate ratios (IRRs) with 95% CIs using modified Poisson regression for TNFi-treated versus biologics-naïve PsA patients and versus the general population adjusted for age, sex, calendar period and country | ||
| 520 | |a RESULTS: During 59 827 person-years, 40 haematological malignancies occurred among TNFi-treated patients with PsA resulting in a pooled IRR of 0.96 (0.68-1.35) versus biologics-naïve PsA from CRR and an IRR of 0.84 (0.64-1.10) versus biologics-naïve PsA from NPR. The IRR of haematological malignancies in PsA overall versus general population comparators was 1.35 (1.17-1.55). The estimates were largely similar for lymphoid and myeloid malignancies | ||
| 520 | |a CONCLUSIONS: Treatment with TNFi in patients with PsA was not associated with an increased incidence of haematological malignancies. Conversely, a moderately increased underlying risk was seen in patients with PsA compared with the general population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a arthritis, psoriatic | |
| 650 | 4 | |a biological therapy | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a tumor necrosis factor inhibitors | |
| 650 | 7 | |a Tumor Necrosis Factor Inhibitors |2 NLM | |
| 650 | 7 | |a Antirheumatic Agents |2 NLM | |
| 650 | 7 | |a Tumor Necrosis Factor-alpha |2 NLM | |
| 650 | 7 | |a Biological Factors |2 NLM | |
| 650 | 7 | |a Biological Products |2 NLM | |
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| 700 | 1 | |a Baecklund, Eva |e verfasserin |4 aut | |
| 700 | 1 | |a Ballegaard, Christine |e verfasserin |4 aut | |
| 700 | 1 | |a Isomäki, Pia |e verfasserin |4 aut | |
| 700 | 1 | |a Aaltonen, Kalle |e verfasserin |4 aut | |
| 700 | 1 | |a Gudbjornsson, Bjorn |e verfasserin |4 aut | |
| 700 | 1 | |a Love, Thorvardur Jon |e verfasserin |4 aut | |
| 700 | 1 | |a Provan, Sella Aarrestad |e verfasserin |4 aut | |
| 700 | 1 | |a Michelsen, Brigitte |e verfasserin |4 aut | |
| 700 | 1 | |a Sexton, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Dreyer, Lene |e verfasserin |4 aut | |
| 700 | 1 | |a Hellgren, Karin |e verfasserin |4 aut | |
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