Incidence of malignancy in Japanese patients with rheumatoid arthritis

Yamada, Tōru; Nakajima, Ayako; Inoue, Eisuke; Tanaka, Eiichi; Taniguchi, Atsuo; Momohara, Shigeki; Yamanaka, Hisashi

doi:10.1007/s00296-010-1524-0

Cited by 86 publications

(79 citation statements)

References 33 publications

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“…Reduced risk of breast cancer was observed in Caucasians patients with RA. These results are consistent with previous reports from Western countries in RA patients [6, 7, 12–22, 24]. It has been reported that the epidemiology of malignancy in Japan differed from that in Western countries.…”

Section: Discussionsupporting

confidence: 93%

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Breast Cancer Risk in Rheumatoid Arthritis: An Update Meta-Analysis

Tian

Liang

Wang

et al. 2014

BioMed Research International

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Background. The incidence of breast cancer in RA patients remains controversial. Thus we performed a meta-analysis to investigate the impact of RA on breast cancer. Methods. Published literature was available from PubMed, Embase, and Cochrane Library. Pooled standardized incidence rate (SIR) was computed by random-effect model analysis. Results. We identified 16 separate studies in the present study, in which the number of patients ranged from 458 to 84,475. We did not find the increased cancer risk in RA patients (SIR = 0.86, 95% CI = 0.72–1.02). However, subgroup analysis showed that breast cancer risk in RA patients was positively different in Caucasians (SIR = 0.82, 95% CI = 0.73–0.93) and non-Caucasians (SIR = 1.21, 95% CI = 1.19–1.23), respectively. In subgroup analysis by style, a reduced incidence was found in hospital-based case subjects (SIR = 0.82, 95% CI = 0.69–0.97). Similarly, subgroup analysis for adjusted factors indicated that in A3 (age and sex) and A4 (age, sex, and race/ethnicity) the risk was decreased (SIR = 0.87, 95% CI = 0.76–0.99; SIR = 0.63, 95% CI = 0.59–0.67). Conclusions. The meta-analysis revealed no increased breast cancer risk in RA patients. However, in the subgroup analysis, the risk of breast cancer is increased in non-Caucasians patients with RA while it decreased in Caucasian population, hospital-based case subjects, and A3 group. Such relationship may provide preference for risk of breast cancer in different population.

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Section: Discussionsupporting

confidence: 93%

“…It has been reported that the epidemiology of malignancy in Japan differed from that in Western countries. In Japanese population, breast cancer became the worst type of tumor followed by uterus and stomach cancers in women [6]. …”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Risk in Rheumatoid Arthritis: An Update Meta-Analysis

Tian

Liang

Wang

et al. 2014

BioMed Research International

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“…Notably, about half the patients who developed serious infections within the first year of initiating TCZ treatment and who had subsequently discontinued treatment were older, had longer disease duration, and had more respiratory comorbidities compared with patients who had a presumed lower risk of serious infection and remained in the Malignant lymphoma occurs with a significantly higher incidence in patients with RA compared with the general population 12 . The SIR for malignancies in our study were lower than those reported to date in a large cohort of Japanese patients with RA 13 . The SIR for malignant lymphoma in the current study were not higher than those in biologic-experienced Japanese patients with RA reported by the Japan College of Rheumatology 14 .…”

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confidence: 54%

Longterm Safety of Tocilizumab: Results from 3 Years of Followup Postmarketing Surveillance of 5573 Patients with Rheumatoid Arthritis in Japan

et al. 2015

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Objective.To evaluate the longterm safety of tocilizumab (TCZ) for the treatment of rheumatoid arthritis (RA) in a real-world clinical setting in Japan.Methods.In this longterm extension of a single-arm, observational postmarketing surveillance study, a total of 5573 patients who initiated intravenous TCZ between April 2008 and July 2009 were observed for 3 years, regardless of its continuation, for incidence of fatal events, serious infections, malignancy, gastrointestinal perforations, and serious cardiac dysfunction.Results.Of the 5573 patients who were enrolled, 4527 patients (81.23%) completed 3 years of followup. There were no increases in the proportions of patients with fatal events, serious infection, malignancy, GI perforation, or serious cardiac dysfunction over 3 years. The all-cause mortality rate during followup was 2.58% (0.95/100 patient-yrs), and the standardized mortality ratio was 1.27 (95% CI, 1.08 to 1.50). Patients who were older with longer disease duration and respiratory comorbidities were more likely to discontinue TCZ treatment following serious infection during the first year. Among patients who completed 3 years of TCZ treatment, serious infection developed at a constant rate during the 3-year treatment period. The proportion of malignancy during followup was 2.24% (0.83/100 patient-yrs), and the standardized incidence ratio was 0.79 (95% CI, 0.66 to 0.95).Conclusion.The safety profile of TCZ was consistent over time regarding mortality, serious infections, malignancy, gastrointestinal perforation, and serious cardiac dysfunction. These data confirm the longterm safety of TCZ use in patients with RA in a real-world clinical setting.

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“…1 Pitting edema of the hands, synovitis, and failure to grip. (From [7], with permission) 437.1 per 100,000 person-years [36]. In a recent study of malignancy association with PMR in the UK, there was a 69 % increased risk of a cancer diagnosis within the first 6 months after a diagnosis of PMR.…”

Section: Rs3pe Is a Syndrome And Associated With Numerous Disordersmentioning

confidence: 97%

RS3PE: Clinical and Research Development

Altman

Yao

2015

Curr Rheumatol Rep

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Remitting seronegative symmetrical synovitis with pitting edema or RS3PE is a rare elderly-onset rheumatic syndrome. Although there are overlapping clinical manifestations between RS3PE, elderly-onset rheumatoid arthritis, and polymyalgia rheumatica, RS3PE has distinct characteristics. RS3PE can be associated with neoplasia and various rheumatic conditions, suggesting that it may be heterogeneous, and is considered as a paraneoplastic rheumatic disease. The pathogenesis of RS3PE may involve vascular endothelial growth factor and infection in RS3PE based upon limited data. Patients with RS3PE without concomitant malignancy respond well to small doses of glucocorticoids and carry good prognosis.

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Incidence of malignancy in Japanese patients with rheumatoid arthritis

Cited by 86 publications

References 33 publications

Breast Cancer Risk in Rheumatoid Arthritis: An Update Meta-Analysis

Breast Cancer Risk in Rheumatoid Arthritis: An Update Meta-Analysis

Longterm Safety of Tocilizumab: Results from 3 Years of Followup Postmarketing Surveillance of 5573 Patients with Rheumatoid Arthritis in Japan

RS3PE: Clinical and Research Development

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