Department of Rheumatology, Gentofte University Hospital, Hellerup, Denmark.
Ann Rheum Dis. 2013 Jan;72(1):79-82. doi: 10.1136/annrheumdis-2012-201969. Epub 2012 Sep 3.
To investigate the incidence of cancer in arthritis patients treated with or without TNFα inhibitors (TNF-I).
Arthritis patients from the DANBIO database were followed-up for cancer in the Danish Cancer Registry during 2000-2008.
Hazard ratio for cancer overall was 1.02 (95% confidence interval (CI) 0.80-1.30) in 3347 TNF-I-treated RA patients compared to non-treated. Excess among TNF-I-treated was found for colon cancer (HR 3.52 (95%CI 1.11-11.15), whereas 6 and 0 ovarian cancer cases were observed in treated and non-treated patients, respectively. Compared to the general population, TNF-I-treated RA patients had increased risk for cancer overall, cancer in lymphatic-haematopoietic tissue and non-melanoma skin cancer, while non-RA patients had no increase in overall cancer risk.
Our results suggest that TNF-I therapy in routine care is not associated with an overall excess of cancer in arthritis patients, but observed increased risks of colon and ovarian cancer need further investigation.
研究接受或未接受 TNFα 抑制剂（TNF-I）治疗的关节炎患者癌症的发病率。
在 2000-2008 年期间，从 DANBIO 数据库中随访关节炎患者在丹麦癌症登记处的癌症情况。
与未治疗的患者相比，3347 例接受 TNF-I 治疗的类风湿关节炎患者的癌症总风险比为 1.02（95%置信区间（CI）0.80-1.30）。在 TNF-I 治疗组中，结肠癌的发病率过高（HR 3.52（95%CI 1.11-11.15）），而治疗组和未治疗组分别观察到 6 例和 0 例卵巢癌病例。与一般人群相比，接受 TNF-I 治疗的类风湿关节炎患者的癌症总发病率、淋巴血液组织癌和非黑色素瘤皮肤癌的风险增加，而非类风湿关节炎患者的总体癌症风险没有增加。
我们的结果表明，常规护理中 TNF-I 治疗与关节炎患者的癌症总体过度无关，但观察到的结肠癌和卵巢癌风险增加需要进一步调查。
