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News

TNF-alpha antagonists do not increase the risk fo cancer in IBD

This week's issue of the Journal of the American Medical Association examines the association between tumor necrosis ractor-α antagonists and risk of cancer in patients with inflammatory bowel disease.

News image

Dr Tine Jess and colleagues investigated whether patients with inflammatory bowel disease (IBD) exposed to TNF-α antagonists were at increased risk of developing cancer.

The team performed a nationwide register-based cohort study in Denmark, 1999-2012.

Participants were 56,146 patients 15 years or older with IBD identified in the National Patient Registry, of whom 4553 were exposed to TNF-α antagonists.

Cancer cases were identified in the Danish Cancer Registry.
about 2% of patients exposed to TNF-α antagonists developed cancer
Journal of the American Medical Association

The research team's main ouctomes included rate ratios for incident cancer comparing TNF-α antagonist users and nonusers, estimated using Poisson regression adjusted for age, calendar year, disease duration, propensity scores, and use of other IBD medications.

During 489,433 person-years of follow-up, about 2% of patients exposed to TNF-α antagonists, and 7% of unexposed patients developed cancer, yielding a fully adjusted RR of 1.07.

The team found no significantly increased risk of cancer in analyses according to time since first TNF-α antagonist exposure, and in analyses according to the number of TNF-α antagonist doses received.

The researchers noted that no site-specific cancers were in significant excess in fully adjusted models.

Dr Jess' team commented, "In this Danish nationwide study, exposure to TNF-α antagonists among patients with IBD was not associated with an increased risk of cancer over a median follow-up of 3.7 years among those exposed."

"An increased risk associated with longer-term accumulated doses and follow-up cannot be excluded."

JAMA 2014;311(23): 2406-2413
19 June 2014

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