Read more

December 26, 2019
2 min read
Save

Anti-TNF alpha not linked with recurrent, new primary cancers in IBD

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Patients with inflammatory bowel disease and other immune-mediated diseases treated with anti-TNF alpha who previously had cancer are not at greater risk for recurrent or new primary cancers, according to the results of a population-based study.

“Historically, clinicians have been concerned about whether [anti-TNF alpha] therapies predispose people to cancer, resulting in a reluctance to prescribe these medications to patients with a history of cancer,” Akbar K. Waljee, MD, of the division of gastroenterology and hepatology at the University of Michigan, and colleagues wrote. “Because [anti-TNF alpha] therapy is often avoided in patients with a history of cancer, little is known about the risk of recurrent cancers in association with anti-TNF use.”

Researchers recruited adults with either IBD, rheumatoid arthritis (RA) or psoriasis and a primary cancer between 1999 and 2016 from the Danish National Patient registry and the Danish Cancer registry (n = 25,738). They matched patients 1:10 between those treated with anti-TNF and those who were not. They excluded patients who were diagnosed with cancer before their first anti-TNF treatment, individuals diagnosed with IBD, RA or psoriasis after anti-TNF alpha initiation, as well as patients who had less than five matched controls.

Investigators estimated the development of recurrent or new primary cancer in patients who received anti-TNF (n = 434) compared with patients who did not (n = 4,328).

During 18,752 person-years of follow-up, Waljee and colleagues identified 635 individuals who developed recurrent or new primary cancer, including 72 who received anti-TNF and 563 who did not.

The incidence of recurrent or new primary cancer was 30.3 cases per 1,000 person-years among the anti-TNF group (95% CI, 24–38.2) compared with 34.4 cases per 1,000 person-years in the control group (31.7–37.3; adjusted HR = 0.82; 95 % CI, 0.61–1.11). In the group treated with anti-TNF, the median time between treatment initiation and recurrent or new primary cancer was 2.8 years (interquartile range = 1.7–5.4 years).

Waljee and colleagues wrote that their findings show that anti-TNF alpha therapy did not lead to increased risk for recurrent or new primary cancers in patients with IBD, RA or psoriasis and a history of cancer.

“Our real-life observational study provides the scale and duration of follow-up needed to address the safety of anti-TNF therapy in people with a history of cancer,” they wrote. “These observations might guide clinical decision-making among providers treating immune-mediated diseases with anti-TNF alpha medications.” – by Alex Young

Disclosure: The authors report no relevant financial disclosures.