A meta-analysis of the incidence of malignancy in adult patients with rheumatoid arthritis

Smitten, Allison; Simon, Teresa A.; Hochberg, Marc C.; Suissa, Samy

doi:10.1186/ar2404

Cited by 375 publications

(358 citation statements)

References 28 publications

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“…Rezultati su pokazali da je jedini važan faktor rizika za peptički ulkus kod bolesnika koji su uzimali NSAIL bila infekcija sa Helicobacter pylori (stepen vjerovatnoće 3,10; 95% CI 1,30-7,30), dok dispepsija, muški pol, godine starosti i anemija, prema rezultatima ovog istraživanja, nisu bili značajni faktori rizika. Zaključeno je da upotreba NSAIL povećava rizik od peptičkog ulkusa 3-5 puta u bolesnika sa Helicobacter pylori pozitivnim, ali i sa Helicobacter pylori negativnim testom [22][23][24][25][26].…”

Section: Diskusijaunclassified

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Komorbiditeti kod oboljelih od reumatoidnog artritisa

Radić

Prodanović

Kovačević

et al. 2016

Biomedicinska istraž.

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Kratak sadržajUvod. Reumatoidni artritis je sistemsko, autoimunsko oboljenje koje dovodi do deformacija i destrukcija zglobova, smanjujući radnu sposobnost oboljelog i značajno utičući na kvalitet života. Bolest u oko 80% bolesnika počinje postepeno, a klinički se ispolji nakon neke infekcije, tjelesne ili psihičke traume, ili porođaja. Komorbiditeti (pridružena oboljenja) nisu rijetki kod bolesnika sa reumatoidnim artritisom, pa prosječno kod pojedinog bolesnika sa reumatoidnim artritisom postoji 1,6 komorbiditeta. Cilj istraživanja je ispitivanje učestalosti pridruženih bolesti kod bolesnika sa reumatoidnim artritisom, kao i promjene te učestalosti tokom jednogodišnjeg praćenja.Metode. Istraživanjem je obuhvaćeno 50 bolesnika sa reumatoidnim artritisom koji su liječeni ambulantno i hospitalno na području Hercegovine. Dijagnoza je postavljena prema revidiranim kriterijumima Američkog udruženja reumatologa iz 1987. godine.Rezultati. Među bolesnicima liječenim od reumatoidnog artritisa bilo je više žena (74%) nego muškaraca (20%). Prosječna starosna dob žena bila je 55,6±12,6 godina, a muškaraca 58,1±11,2 godine. Najveći broj ispitanika (26%) oboljelih od reumatoidnog artritisa imalo je kardiovaskularne bolesti (hipertenzija, angina pektoris, valvularne bolesti srca), 12% ispitanika bolesti endokrinog sistema (diabetes mellitus i bolesti štitaste žlijezde) i 4% ispitanika bolesti gastrointestinalnog trakta. Tokom praćenja povećavala se učestalost svih komorbiditeta.Zaključak. Visok procenat bolesnika sa reumatoidnim artritisom ima pridružena oboljenja među kojima svojom učestalošću prednjače bolesti kardiovaskularnog sistema.

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Section: Diskusijaunclassified

“…Ovi nalazi su bili nezavisni od starosti, pola i statusa pušenja. Potrošnja oralnih kortikosteroida se smanjila za 50%, dok je stopa imunizacije oboljelih od RA protiv gripa poboljšana za 86%, a protiv pneumokoka do 65% [24][25][26][27][28][29][30].…”

Section: Diskusijaunclassified

Komorbiditeti kod oboljelih od reumatoidnog artritisa

Radić

Prodanović

Kovačević

et al. 2016

Biomedicinska istraž.

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“…82 When compared with the general population, the standardized incidence ratio (SIR) estimates suggested that patients with RA had a twofold increase in lymphoma risk (SIR 2.08; 95% CI 1.80-2.39) and a greater risk of Hodgkin than non-Hodgkin lymphoma. The risk of lung cancer was also increased (SIR 1.63; 95% CI 1.43-1.87).…”

Section: Malignanciesmentioning

confidence: 99%

“…[82][83][84][85][86][87][88] Population studies for data collection from primary sources are required to widen the knowledge on the mechanisms of malignancy occurrence in patients with RA.…”

Section: Malignanciesmentioning

confidence: 99%

Consenso 2012 da Sociedade Brasileira de Reumatologia sobre o manejo de comorbidades em pacientes com artrite reumatoide

Pereira¹,

Mota²,

Cruz³

et al. 2012

Rev. Bras. Reumatol.

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Objective: To elaborate recommendations of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology (SBR) to manage comorbidities in rheumatoid arthritis (RA). Methods: To review the literature and the opinions of the SBR RA Committee experts. Results and conclusions: Recommendations: 1) Early diagnosis and proper treatment of comorbidities are recommended; 2) The specifi c treatment of RA should be adapted to the presence of comorbidities; 3) Angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers are preferred to treat systemic arterial hypertension; 4) In patients diagnosed with rheumatoid arthritis and diabetes mellitus, the continuous use of a high cumulative dose of corticoids should be avoided; 5) Statins should be used to maintain LDL cholesterol levels under 100 mg/dL and the atherosclerotic index lower than 3.5 in patients with RA who have other comorbidities; 6) Metabolic syndrome should be treated; 7) Performing non-invasive tests to investigate subclinical atherosclerosis is recommended; 8) Greater surveillance for the early diagnosis of occult malignancy is recommended; 9) Preventive measures of venous thrombosis are suggested; 10) Bone densitometry is recommended in RA patients over the age of 50 years and in younger patients on corticoid therapy at a dose greater than 7.5 mg for over three months; 11) Patients with RA and osteoporosis should be instructed to avoid falls, to increase their dietary calcium intake and sun exposure, and to exercise; 12) Calcium and vitamin D supplementation is suggested. Bisphosphonates are suggested for patients with T score < -2.5 on bone densitometry; 13) A multidisciplinary team, with the active participation of a rheumatologist, is recommended to treat comorbidities.

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“…Patients with RA may have an increased risk of infection and some organ-specific malignancies 1,2 . Therefore, it is particularly important to monitor the incidence of infections and malignancies together with other adverse events (AE) in patients with RA treated with immunomodulatory agents.…”

mentioning

confidence: 99%

Longterm Safety and Efficacy of Subcutaneous Abatacept in Patients with Rheumatoid Arthritis: 5-year Results from a Phase IIIb Trial

Genovese

Pacheco‐Tena²,

Covarrubias³

et al. 2018

J Rheumatol

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Objective.To assess 5-year safety, tolerability, and efficacy of subcutaneous (SC) abatacept (ABA) in methotrexate (MTX)-refractory patients with rheumatoid arthritis (RA).Methods.The Abatacept Comparison of sub[QU]cutaneous versus intravenous in Inadequate Responders to methotrexatE (ACQUIRE) phase IIIb, randomized, double-dummy, multinational trial compared efficacy and safety of SC and intravenous (IV) ABA in patients with RA. In the initial 6-month double-blind (DB) period, patients received IV or SC ABA, plus MTX, and in the subsequent open-label longterm extension (LTE) period, all patients received SC ABA (125 mg/wk). The final 5-year safety, tolerability, and efficacy analyses are reported.Results.Of 1385 patients who completed the DB period, 1372 entered LTE and 945 (68.8%) completed ≥ 5 years of treatment. During LTE, 97 (7.1%) patients discontinued treatment because of an adverse event (AE). Incidence rate (IR; event/100 patient-yrs of exposure; based on LTE data, 95% CI) for AE of interest were the following: serious AE 7.73 (6.96–8.58), infection 38.60 (36.24–41.12), serious infection 1.68 (1.35–2.07), malignancies 1.09 (0.84–1.42), and autoimmune disorders 1.33 (1.05–1.69), and were stable over time. No association between immunogenicity and either worsening of ABA safety or loss of efficacy was noted. Efficacy in the LTE was consistent with the DB period and was maintained to the end of the study.Conclusion.These 5-year data establish that SC ABA (125 mg/wk) has a consistent safety profile and durable efficacy for longterm treatment of patients with RA who had an inadequate response to MTX.

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A meta-analysis of the incidence of malignancy in adult patients with rheumatoid arthritis

Abstract: Introduction The risk of malignancies in patients with rheumatoid arthritis (RA) has raised some concern, particularly with immunosuppressive approaches to disease management.

Cited by 375 publications

References 28 publications

Komorbiditeti kod oboljelih od reumatoidnog artritisa

Komorbiditeti kod oboljelih od reumatoidnog artritisa

Consenso 2012 da Sociedade Brasileira de Reumatologia sobre o manejo de comorbidades em pacientes com artrite reumatoide

Longterm Safety and Efficacy of Subcutaneous Abatacept in Patients with Rheumatoid Arthritis: 5-year Results from a Phase IIIb Trial

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