Incidence of malignancy in adult patients with rheumatoid arthritis: a meta-analysis

Simon, Teresa A.; Thompson, Adam; Gandhi, Kunal K.; Hochberg, Marc C.; Suissa, Samy

doi:10.1186/s13075-015-0728-9

Cited by 377 publications

(330 citation statements)

References 39 publications

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“…Similar to previous reports, there was a low rate of opportunistic infections and new tuberculosis infections or reactivation 9 . Further, the IR for malignancy (1.09) and autoimmune disorders (1.33) reported here were similar to those reported for patients with RA treated with IV and SC ABA over the long term (malignancy 1.32; autoimmune disorders 1.37) 9 , and standardized IR estimated for patients with RA in population-and community-based cohorts (malignancy 1.06-1.13) 2 .…”

Section: Rheumatologysupporting

confidence: 68%

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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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Section: Rheumatologysupporting

confidence: 68%

“…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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“…were used to summarize the characteristics of each cohort, and comparisons between cohorts were performed using 2 and rank sum tests. The cumulative incidences of all cancers and skin cancers (including melanoma and NMSC), adjusted for the competing risk of death, were estimated [16].…”

Section: Resultsmentioning

confidence: 99%

“…Epidemiological studies have shown that chronic inflammatory diseases, such as RA and SLE, are associated with increased risk of haematological, cutaneous and solidorgan malignancies [1,2]. Even limited autoimmune dermatological conditions, such as psoriasis, are associated with increased risk of both cutaneous and systemic solid-organ malignancies [3].…”

Section: Introductionmentioning

confidence: 99%

Cancer risk in cutaneous lupus erythematosus: a population-based cohort study

Singh¹,

Crowson²,

Singh³

et al. 2016

Rheumatology

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Objective. Immune dysregulation associated with chronic autoimmune diseases, such as SLE, has been associated with increased cancer risk. It is unclear whether isolated cutaneous lupus erythematosus (CLE) modifies cancer risk. We estimated the cumulative incidence of cancer in a population-based CLE cohort and compared the risk with a matched non-CLE cohort.Methods. All incident cases of CLE in Olmsted County, MN, USA between 1965 and 2005 were identified and followed to December 2013. Estimates for the cumulative incidence of any cancer and skin cancer in patients with CLE were derived and compared with an age-, sex-and calendar-year-matched non-CLE cohort using Cox models.Results. There were a total of 155 patients with CLE [age at diagnosis, 48 (S.D. 16) years; 65% females; BMI, 26.3 (S.D. 7.1) kg/m 2 ; 40% smokers, 9% with diabetes]. During a median follow-up of 14.6 years, we observed 35 cases of incident cancer (including 10 cases of skin cancer). The cumulative 1-, 5-and 10-year incidence of any cancer after diagnosis of CLE was 1.4, 7.5 and 11.6%, respectively. Compared with matched non-CLE controls, the overall risk of malignancies was not increased in patients with CLE (smoking-adjusted hazard ratio = 1.29; 95% CI: 0.78, 2.13; P = 0.31). There was also no significant increase in risk of any skin cancer in patients with CLE (hazard ratio = 2.51; 95% CI: 0.91, 6.96; P = 0.16).Conclusion. CLE is not associated with an increased risk of any cancers, including skin cancers, compared with the general population. However, the number of events was small, limiting the power of the study.

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“…Romatoid artritli erkek ve kadin hastalarda Hodgkin Hastaliği, Non-Hodgkin lenfoma gibi lenfoproliferatif kanserlerde ve akciğer kanserinde artmiş risk olduğu bildirilmiştir [7]. Tümör ilişkili antijenlerden CEA kolorektal kanserlerde, CA-15-3 meme kanserinde, CA-19-9 pankreatik karsinomlarda ve CA-125 over kanserleri takiplerinde kullanilmaktadir.…”

Section: Discussionunclassified

Increased serum tumor markers in a patient with rheumatoid arthritis

Bayğın¹,

Sargın²,

Şentürk³

et al. 2017

Pau Med J

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ÖzetTümör ilişkili antijenler, malignitelerde takip ve tedaviye yanitin değerlendirilmesinde kullanilir. Antijenler inflamatuar hücreler tarafindan eksprese edilebilir ve malin hücrelerin adezyon ve metastazlarinda önemli rol oynabilir. İnflamatuar romatizmal hastaliklarin akciğer tutulumu ve plevral effüzyonu bulunan hastalarda tümör ilişkili antijen seviyelerinin arttiği rapor edilmiştir. Biz, RA tanili bir kadin hastada tümör belirteçleri ile hastalik aktivitesi arasindaki ilişkiyi sunmayi amaçladik. Bir yildan beri RA tanisi olan 61 yaşinda kadin hasta, sağ dizde, her iki el bileğinde ve metakarpofalangeal eklemlerde şişlik ve hassasiyet olmasi nedeniyle kliniğimize başvurdu. Özgeçmişinde leflunomid 20 mg/gün ve sulfasalazin 2 gr/gün kullanimi dişinda bir özellik yoktu. Fizik muayenede bilateral akciğer alt zonda raller mevcuttu. Hastanin laboratuvar verileri: hastalik aktivite skoru : 6,02, eritrosit sedimentasyon hizi [ESH]: 72 mm/h, CRP: 37,95 mg/l, romatoid faktör: 48,5 IU/ml, anti-CCP: 67,1 U/ml, CA19-9: 410,67 U/ml [0-37 U/ml], CA-125: 197,1 U/ml [0-35 U/ml] ve CA-15-3: 51,6 U/ml [0-31,3 U/ml] idi. Postero-anterior akciğer grafisinde bilateral orta ve alt zonlarda retiküler dansite artişi ve toraks BT'de her iki akciğerde retiküler, buzlu cam opasiteleri ve ince bal peteği değişiklikleri görüldü. Malignite lehine herhangi bir kanit yoktu ve aktif hastaliği olan hastaya anti-inflamatuar tedavi verildi. Takiplerde, ESH, CRP, DAS-28, CA19-9, CA-125 ve CA15-3 düzeyleri geriledi. RA' da hastalik aktivitesini, organ hasarini ve tedaviye yaniti belirlemek için ideal biyobelirteçlere ihtiyaç vardir. Bağ doku hastaliklarinda organ tutulumu ile tümör belirteçleri arasindaki ilişki nedeniyle, bu biyobelirteçler hastalik progresyonu ve tedaviye yanitin değerlendirilmesinde yardimci olabilir. Tümör belirteçleri, malignite ekarte edildikten sonra, RA hastalarinda (özellikle akciğer tutulumlu) hastalik aktivitesinin değerlendirilmesinde kullanilabilir. Pam Tıp Derg 2017;10(1):81-85Anahtar sözcükler: Romatoid artrit, tümor belirteçleri, hastalik aktivitesi. AbstractTumor-associated antigens are used to assess the response to treatment and follow-up of malignancies.They may be expressed by inflammatory cells, and play an important role in the adhesion and metastasis of malignant cells. Increased level of tumor associated antigens were reported in patients with pleural effusion and pulmonary involvement of inflammatory rheumatic diseases.We aimed to present the relationship between tumor markers and disease activity in a female patient diagnosed with RA.61-year-old female patients diagnosed with RA since one year was admitted to our clinic with the tenderness and swelling of her right knee, both wrists and metacarpophalangeal joints. She had no medical history, except for taking leflunomide 20 mg/day and sulfasalazine 2 g/day.Physical examination revealed bilateral pulmonary crackles in the lower zone. The laboratory findings of the patients were as follows: Disease activity score was 6.02,erythrocyte sedimentation rat...

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Incidence of malignancy in adult patients with rheumatoid arthritis: a meta-analysis

Cited by 377 publications

References 39 publications

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

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

Cancer risk in cutaneous lupus erythematosus: a population-based cohort study

Increased serum tumor markers in a patient with rheumatoid arthritis

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