Rheumatoid Arthritis Clinical Studies

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Cancer risk in patients with rheumatoid arthritis treated with anti–tumor necrosis factor α therapies: Does the risk change with the time since start of treatment?

  1. Johan Askling1,†,*,
  2. Ronald F. van Vollenhoven1,†,
  3. Fredrik Granath1,‡,
  4. Pauline Raaschou1,
  5. C. Michael Fored1,
  6. Eva Baecklund2,§,
  7. Christina Dackhammar3,
  8. Nils Feltelius4,
  9. Lars Cöster5,
  10. Pierre Geborek6,
  11. Lennart T. Jacobsson7,
  12. Staffan Lindblad1,
  13. Solbritt Rantapää-Dahlqvist8,
  14. Tore Saxne6,
  15. Lars Klareskog1,¶

Article first published online: 29 OCT 2009

DOI: 10.1002/art.24941

Issue

Arthritis & Rheumatism

Arthritis & Rheumatism

Volume 60, Issue 11, pages 3180–3189, November 2009

Additional Information

How to Cite

Askling, J., van Vollenhoven, R. F., Granath, F., Raaschou, P., Fored, C. M., Baecklund, E., Dackhammar, C., Feltelius, N., Cöster, L., Geborek, P., Jacobsson, L. T., Lindblad, S., Rantapää-Dahlqvist, S., Saxne, T. and Klareskog, L. (2009), Cancer risk in patients with rheumatoid arthritis treated with anti–tumor necrosis factor α therapies: Does the risk change with the time since start of treatment?. Arthritis & Rheumatism, 60: 3180–3189. doi: 10.1002/art.24941

Author Information

  1. 1

    Karolinska University Hospital at Solna and Karolinska Institutet, Stockholm, Sweden

  2. 2

    Uppsala University Hospital, Uppsala, Sweden

  3. 3

    Sahlgrenska University Hospital, Gothenburg, Sweden

  4. 4

    Karolinska University Hospital at Solna and Karolinska Institutet, Stockholm, Sweden, and Medical Products Agency, Uppsala, Sweden

  5. 5

    Linköping University Hospital, Linköping, Sweden

  6. 6

    Lund University Hospital, Lund, Sweden

  7. 7

    Malmö University Hospital, Malmö, Sweden

  8. 8

    Norrland University Hospital, Umeå, Sweden

  1. †

    Drs. Askling and von Vollenhoven have each received consulting fees, speaking fees, and/or honoraria from Wyeth, Schering-Plough, and Abbott (less than $10,000 each).

  2. ‡

    Dr. Granath owns stock or stock options in AstraZeneca.

  3. §

    Dr. Baecklund has received consulting fees, speaking fees, and/or honoraria from Schering-Plough.

  4. Dr. Klareskog has received research grants from Schering-Plough, Wyeth, Abbott, Roche, Bristol-Myers Squibb, and AstraZeneca.

*Clinical Epidemiology Unit T2, Department of Medicine Solna, Karolinska University Hospital at Solna, 171 76 Stockholm, Sweden

Publication History

  1. Issue published online: 29 OCT 2009
  2. Article first published online: 29 OCT 2009
  3. Manuscript Accepted: 11 JUL 2009
  4. Manuscript Received: 20 FEB 2009

Funded by

  • Swedish Cancer Society
  • Stockholm County Council
  • ARTIS
  • Swedish Biologics Register
  • Wyeth-Ayerst
  • Schering-Plough
  • Abbott Immunology
  • Roche
  • Bristol-Myers Squibb
  • The South Swedish Anti-TNF Register has received funding from the King Gustav V
  • Österlund
  • Kock Foundations
  • Reumatikerförbundet
  • Swedish National Board of Health and Welfare

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REFERENCES

  • 1
    Balkwill F. TNF-α in promotion and progression of cancer. Cancer Metastasis Rev 2006; 25: 409–16.
  • 2
    Van Horssen R, Ten Hagen TL, Eggermont AM. TNF-α in cancer treatment: molecular insights, antitumor effects, and clinical utility. Oncologist 2006; 11: 397–408.
  • 3
    Perkins ND. NF-κB: tumor promoter or suppressor? Trends Cell Biol 2004; 14: 64–9.
  • 4
    Brown SL, Greene MH, Gershon SK, Edwards ET, Braun MM. Tumor necrosis factor antagonist therapy and lymphoma development: twenty-six cases reported to the Food and Drug Administration. Arthritis Rheum 2002; 46: 3151–8.
    Direct Link:
  • 5
    Bongartz T, Sutton AJ, Sweeting MJ, Buchan I, Matteson EL, Montori V. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA 2006; 295: 2275–85.
  • 6
    Bongartz T, Warren FC, Mines D, Matteson EL, Abrams KR, Sutton AJ. Etanercept therapy in rheumatoid arthritis and the risk of malignancies: a systematic review and individual patient data meta-analysis of randomised controlled trials. Ann Rheum Dis 2009; 68: 1177–83.
  • 7
    Leombruno JP, Einarson TR, Keystone EC. The safety of anti-tumor necrosis factor treatments in rheumatoid arthritis: meta and exposure adjusted pooled analyses of serious adverse events. Ann Rheum Dis 2009; 68: 1136–45.
  • 8
    The Wegener's Granulomatosis Etanercept Trial (WGET) Research Group. Etanercept plus standard therapy for Wegener's granulomatosis. N Engl J Med 2005; 352: 351–61.
  • 9
    Remicade (infliximab) medication guide. Malvern (PA): Centocor Ortho Biotech; 2009. URL: http://www.remicade.com/pdf/HCP_PPI.pdf.
  • 10
    Askling J, Fored M, Brandt L, Baecklund E, Bertilsson L, Feltelius N, et al. Risks of solid cancers in patients with rheumatoid arthritis and following treatment with TNF-antagonists. Ann Rheum Dis 2005; 64: 1421–26.
  • 11
    Setoguchi S, Solomon DH, Weinblatt ME, Katz JN, Avorn J, Glynn RJ, et al. Tumor necrosis factor α antagonist use and cancer in patients with rheumatoid arthritis. Arthritis Rheum 2006; 54: 2757–64.
    Direct Link:
  • 12
    Wolfe F, Michaud K. Biologic treatment of rheumatoid arthritis and the risk of malignancy: analyses from a large US observational study. Arthritis Rheum 2007; 56: 2886–95.
    Direct Link:
  • 13
    Ray WA. Evaluating medication effects outside of clinical trials: new-user designs. Am J Epidemiol 2003; 158: 915–20.
  • 14
    Cancer incidence in Sweden 2005. Stockholm: National Board of Health and Welfare; 2007.
  • 15
    Askling J, Fored CM, Geborek P, Jacobsson LT, van Vollenhoven R, Feltelius N, et al. Swedish registers to address drug safety and clinical issues in rheumatoid arthritis. Ann Rheum Dis 2006; 65: 707–12.
  • 16
    International classification of diseases, seventh revision. Geneva: World Health Organization; 1955.
  • 17
    Baecklund E, Iliadou A, Askling J, Ekbom A, Backlin C, Granath F, et al. Association of chronic inflammation, not its treatment, with increased lymphoma risk in rheumatoid arthritis. Arthritis Rheum 2006; 54: 692–701.
    Direct Link:
  • 18
    Simonsson M, Bergman S, Jacobsson LT, Petersson IF, Svensson B. The prevalence of rheumatoid arthritis in Sweden. Scand J Rheumatol 1999; 28: 340–3.
  • 19
    Mellemkjaer L, Linet MS, Gridley G, Frisch M, Moller H, Olsen JH. Rheumatoid arthritis and cancer risk. Eur J Cancer 1996; 32A: 1753–7.
  • 20
    Mattsson B, Wallgren A. Completeness of the Swedish Cancer Register: non-notified cancer cases recorded on death certificates in 1978. Acta Radiol Oncol 1984; 23: 305–13.
  • 21
    Geborek P, Bladstrom A, Turesson C, Gulfe A, Petersson I, Saxne T, et al. TNF blockers do not increase overall tumour risk in patients with rheumatoid arthritis, but may be associated with increased risk of lymphomas. Ann Rheum Dis 2005; 64: 699–703.
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