Lymphomas during long-term methotrexate therapy

Kamel, O. W.

doi:10.1001/archderm.133.7.903

Cited by 6 publications

(2 citation statements)

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“…The immunologic nature of psoriasis has raised concern that its pathophysiology may be associated with an increased risk of lymphoma, as has been demonstrated previously for other Th-1 mediated diseases such as rheumatoid arthritis (Gridley et al, 1993;Ekstrom et al, 2003). Additionally, patients with extensive psoriasis may be treated with systemic therapies such as cyclosporine and methotrexate, which have been associated with the development of lymphoma in psoriasis patients treated with these medications (Koo et al, 1992;Kamel et al, 1996Kamel et al, , 1997Cliff et al, 1999;Mahe et al, 2003;Lelievre et al, 2005). Patients with psoriasis are increasingly treated with biologic therapies that target T cells (e.g., efazilumab, alefacept) or cytokines such as tumor necrosis factor-a (infliximab, etanercept, adalimumab).…”

Section: Introductionmentioning

confidence: 96%

The Risk of Lymphoma in Patients with Psoriasis

Gelfand

Shin

Neimann

et al. 2006

Journal of Investigative Dermatology

287

238

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Psoriasis is a common, chronic, inflammatory disease. Psoriasis has been hypothesized to be associated with an increased risk of lymphoma due to its pathophysiology, its treatments, or a combination of these factors. We performed a large population-based cohort study of the risk of lymphoma in psoriasis patients using the General Practice Research Database. We identified 153,197 patients with psoriasis and 765,950 corresponding subjects without psoriasis. Psoriasis patients who received a systemic treatment consistent with extensive disease were classified as severe (N=3,994) and those who did not receive systemic therapies were classified as mild (N=149,203). The analyses were adjusted for age, gender, and person-time using a Cox proportional hazards model. For mild and severe psoriasis patients, the respective adjusted relative risks for lymphoma and its subtypes were as follows: all lymphoma 1.34 (1.16, 1.54) and 1.59 (0.88, 2.89); non-Hodgkin's lymphoma 1.15 (0.97, 1.37) and 0.73 (0.28, 1.96); Hodgkin's lymphoma (HL) 1.42 (1.00, 2.02) and 3.18 (1.01, 9.97); cutaneous T-cell lymphoma (TCL) 4.10 (2.70, 6.23) and 10.75 (3.89, 29.76). Psoriasis is associated with an increased risk of lymphoma. The association is strongest for HL and CTCL. The excess risk of lymphoma attributed to psoriasis was 7.9/100,000 psoriasis patients per year. Although patients with psoriasis have an increased relative risk of lymphoma, the absolute risk attributable to psoriasis is low given that lymphoma is a rare disease and the magnitude of association is modest.

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Section: Introductionmentioning

confidence: 96%

The Risk of Lymphoma in Patients with Psoriasis

Gelfand

Shin

Neimann

et al. 2006

Journal of Investigative Dermatology

287

238

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“…In fact, various studies have suggested that persistent immune stimulation could induce the development of a dominant clone that leads to lymphomagenesis [ 69 , 70 ]. Moreover, prolonged use of systemic immunomodulatory medications such as methotrexate and cyclosporine might be another possible cause for the increased risk of cancer in patients with psoriasis [ 71 , 72 ]. A systematic review by Peleva et al [ 73 ] has revealed that patients treated with TNF inhibitors show a greater risk of NMSC, especially squamous cell carcinoma, than the general population in the United States.…”

Section: The Risk Of Cancer In Psoriasis and Psoriatic Arthritismentioning

confidence: 99%

The Risk of Systemic Diseases in Those with Psoriasis and Psoriatic Arthritis: From Mechanisms to Clinic

Woo

Park

Kang

et al. 2020

IJMS

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Psoriasis and psoriatic arthritis (PsA) have been recently considered as chronic systemic inflammatory disorders. Over the past decades, enormous evidence indicates that patients with psoriasis and PsA have a higher risk of developing various comorbidities including cardiovascular disease, metabolic disease, cancers, infections, autoimmune disease, and psychiatric diseases. However, reported risks of some comorbidities in those with psoriasis and PsA are somewhat different according to the research design. Moreover, pathomechanisms underlying comorbidities of those with psoriasis and PsA remain poorly elucidated. The purpose of this review is to provide the most updated comprehensive view of the risk of systemic comorbidities in those with psoriasis and PsA. Molecular mechanisms associated with the development of various comorbidities in those with psoriasis and PsA are also reviewed based on recent laboratory and clinical investigations. Identifying the risk of systemic comorbidities and its associated pathomechanisms in those with psoriasis and PsA could provide a sufficient basis to use a multi-disciplinary approach for treating patients with psoriasis and PsA.

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