Association Between Tumor Necrosis Factor-α Antagonists and Risk of Cancer in Patients With Inflammatory Bowel Disease

Andersen, Nynne Nyboe; Pasternak, Björn; Basit, Saima; Andersson, Mikael; Svanström, Henrik; Caspersen, Sarah; Munkholm, Pia; Hviid, Anders; Jess, Tine

doi:10.1001/jama.2014.5613

Cited by 241 publications

(172 citation statements)

References 29 publications

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“…The risk of cancer associated with methotrexate therapy has been assessed in patients with rheumatoid arthritis and most studies have not found an increased risk 22 In comparison, treatment with thio-purines increases the risk of lymphoma and nonmelanoma skin cancer. 3,[23][24][25] Nausea and vomiting were the most common minor adverse events associated with methotrexate therapy.…”

Section: Discussionmentioning

confidence: 99%

Methotrexate Is Not Superior to Placebo for Inducing Steroid-Free Remission, but Induces Steroid-Free Clinical Remission in a Larger Proportion of Patients With Ulcerative Colitis

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Methotrexate Is Not Superior to Placebo for Inducing Steroid-Free Remission, but Induces Steroid-Free Clinical Remission in a Larger Proportion of Patients With Ulcerative Colitis

et al. 2016

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“…The possible role of the biological development of solid tumors is not well characterized. Andersen et al (2014) showed no increased risk of solid cancer development in patients exposed to anti-TNF therapy, at a median follow-up of 3.7 years [13].…”

Section: Discussionmentioning

confidence: 92%

Gastric Neoplasia during Anti-TNF Therapy for Crohn’s Disease: Casual Event?

Fortes¹,

Silva²,

Lyra³

et al. 2015

JCT

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The increase risk of cancer development in patients with inflammatory intestinal disease (IBD) has already studied for decades. The anti-TNF therapy has changed the treatment strategy of IBD. By using on a larger scale and for a longer time, the anti-TNF raised concern over its potential adverse events. A male Crohn's disease (CD) patient, 55 years old, diagnosed for nine years, treated with infliximab for 6 years. In 2011, he underwent a nupper endoscopy (UE) which showed flat erosive gastritis with moderate intensity in antrum, gastric polyps and gastric erosion. Pathological examination revealed a chronic gastritis in erosive activity and search for Helicobacter pylori resulted positive. In May 2014, the patient was asymptomatic, when it held UE, which showed suggestive lesion of early gastric cancer, measuring 1.5 cm and search for Helicobacter pylori negative. Histopathological exams confirmed the adenocarcinoma. The patient underwent to a laparoscopic surgery (total gastrectomy with lymphadenectomy and reconstruction Roux-en-Y). Risk factors for the development of gastric cancer in general population are already well defined. However studying a possible association among CD and the different therapeutic modalities used in the treatment of this disease with gastric cancer appearance is important to set specific assessment strategies, prevention and follow-up. While there is no consensus on a proper monitoring for gastric cancer prevention in these patients, individualized conduct, taking into account individual characteristics, family record and other risk factors, should be adopted to avoid unfavorable outcomes in CD patients.

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“…Lymphomas have also been reported in patients treated with anti-tumor necrosis factor-α (TNF-α) drugs, which could act by decreasing apoptosis and allowing proliferation of neoplastic cells [2] , but in most studies, anti-TNF-α appears to have no correlation with lymphomas [10] . In a register-based cohort study conducted by Nyboe Andersen et al [13] , 56,146 patients were included and 8 cases of lymphomas, with 2 HL, were diagnosed. There was a risk of 0.90 (95% CI, 0.42-1.91) for those who were under anti-TNF-α after adjusting the variable to the azathioprine use [13] .…”

Section: Discussionmentioning

confidence: 99%

“…In a register-based cohort study conducted by Nyboe Andersen et al [13] , 56,146 patients were included and 8 cases of lymphomas, with 2 HL, were diagnosed. There was a risk of 0.90 (95% CI, 0.42-1.91) for those who were under anti-TNF-α after adjusting the variable to the azathioprine use [13] . Then, caution must be taken, when associating lymphomas with anti-TNF-α therapy.…”

Section: Discussionmentioning

confidence: 99%

Hodgkin's Lymphoma in Crohn's Disease Treated with Infliximab

Carvalho¹,

Russo²,

Bernardes³

et al. 2017

GE Port J Gastroenterol

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Introduction: Lymphoproliferative disorders, particularly non-Hodgkin's and Hodgkin's lymphomas, are rare in patients with inflammatory bowel diseases. The use of thiopurines and infection by Epstein-Barr virus are well-known cofactors that can raise its prevalence. Other risk factors such as disease activity and biological treatment are the subject of discussion, without enough data in the literature to confirm a potential association. Methods: We report a case of Hodgkin's lymphoma in a patient who had been treated with azathioprine and was on long-term monotherapy with infliximab. Conclusions: We stress the importance of recognizing the possible occurrence of a lymphoproliferative disorder in association with anti-tumor necrosis factor-α therapy

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Association Between Tumor Necrosis Factor-α Antagonists and Risk of Cancer in Patients With Inflammatory Bowel Disease

Cited by 241 publications

References 29 publications

Methotrexate Is Not Superior to Placebo for Inducing Steroid-Free Remission, but Induces Steroid-Free Clinical Remission in a Larger Proportion of Patients With Ulcerative Colitis

Methotrexate Is Not Superior to Placebo for Inducing Steroid-Free Remission, but Induces Steroid-Free Clinical Remission in a Larger Proportion of Patients With Ulcerative Colitis

Gastric Neoplasia during Anti-TNF Therapy for Crohn’s Disease: Casual Event?

Hodgkin's Lymphoma in Crohn's Disease Treated with Infliximab

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