No link between TNF inhibitors, increased risk for cancer in PsA

Registry data from four European countries found no association between treatment with TNF inhibitors for psoriatic arthritis and an overall increase in cancer risk, according to findings presented at the EULAR Annual Congress.

“Our study provides convincing evidence that the use of TNF inhibitors does not increase the risk of overall cancer in patients with psoriatic arthritis,” Lene Dreyer, MD, of Aalborg University and Aalborg University Hospital in Denmark, and of the DANBIO Nationwide registry, said in a press release.

The researchers evaluated risk for a number of malignancies in patients with PsA who were treated with TNF inhibitors and compared those outcomes with risks reported in the general populations of Denmark, Finland, Iceland and Sweden. The analysis included more than 8,000 patients from the four countries, representing 44,041 patient-years of follow-up. The standardized incidence ratio (SIR) for all cancers across the cohort was 1 (95% CI, 0.89-1.13).

Broken down by country, the ratio in Denmark from the DANBIO registry was 0.99 (95% CI, 0.77-1.26), compared with 1.28 (95% CI, 0.82-1.9) from the ROB-FIN registry in Finland, 1.71 (95% CI, 0.88-2.99) for the ICEBIO registry in Iceland, and 0.94 (95% CI, 0.8-1.1) for the ARTIS registry in Sweden.

Regarding specific malignancies, the highest SIR was reported for Hodgkin’s and non-Hodgkin’s lymphoma, at 1.84 (95% CI, 1.2-2.82), followed by colorectal cancer (SIR = 1.21; 95% CI, 0.85-1.71), pancreatic cancer (SIR = 1.21; 95% CI, 0.6-2.41), and breast cancer (SIR = 1.2; 95% CI, 0.93-1.55).

Incidence ratios for malignancies in the lung, brain, uterus, and prostate, along with those for malignant melanoma, were at or below 1, according to the findings.

“Our results suggest that the overall cancer risk for TNF [inhibitor]-treated PsA patients is not increased compared to the general population,” the researchers concluded.

“Further analysis is needed to assess whether the observed increase in malignant lymphomas is due to the psoriatic arthritis disease or the TNF [inhibitor] treatment,” Dreyer added. – by Rob Volansky

Reference:
Ballegaard C, et al. OP0005. Presented at: EULAR Annual Congress; June 12-15, 2019; Madrid.

Disclosure: Lene Dreyer reports consulting for Janssen Pharmaceuticals, MSD and UCB; and being on the speakers’ bureau of Eli Lilly, Janssen Pharmaceuticals, MSD and UCB.