Skeletal Biology and Engineering Research Center, Department of Development and Regeneration KU Leuven; Rheumatology, University Hospitals Leuven, Belgium.
Clin Exp Rheumatol. 2014 Jan-Feb;32(1):71-6. Epub 2013 Dec 2.
To report the incidence of malignancy in a large single-centre cohort in Belgium of patients with spondyloarthritis (SpA) treated with one or more anti-TNF therapies and to compare the results with the incidence of malignancy in the Belgian population.
From September 2000 until March 2010, all SpA patients that started treatment with one or more anti-TNF therapies were included in this single-centre prospective longitudinal observational study. The primary outcome of this study was the incidence of malignancy after starting anti-TNF treatment. Incidence rates were compared with the incidence rates of malignancy in Belgium in 2008 for the 45-50 year-old population, as documented by the Belgian Cancer Registry.
231 patients with a mean age of 47.86 y were included for a total of 1020.74 patient years of treatment and 1199.83 patient years follow-up after the start of treatment. In our study population, 6 out of 231 patients (2.6 %) developed a malignancy after the start of anti-TNF treatment. The overall incidence rate of malignancy in our study population is 500.1 per 100000 patient years, indicating a higher incidence compared to the Belgian population. We see a higher incidence rate in females as well in males; standardised incidence ratios are in the same range for both (154.3 for females and 130.6 for males).
We see a tendency towards a higher incidence of malignancy in SpA patients treated with anti-TNF therapy. However, it is not clear whether this increased risk is disease-related or treatment-related.
报告在比利时一家大型单中心队列中，接受一种或多种抗 TNF 治疗的脊柱关节炎（SpA）患者的恶性肿瘤发病率，并将结果与比利时人群的恶性肿瘤发病率进行比较。
从 2000 年 9 月至 2010 年 3 月，所有开始接受一种或多种抗 TNF 治疗的 SpA 患者均纳入本项单中心前瞻性纵向观察性研究。该研究的主要结局是开始抗 TNF 治疗后恶性肿瘤的发病率。发病率与 2008 年比利时癌症登记处记录的 45-50 岁人群的恶性肿瘤发病率进行比较。
共纳入 231 例患者，平均年龄为 47.86 岁，总治疗时间为 1020.74 患者年，治疗开始后随访时间为 1199.83 患者年。在我们的研究人群中，6 例患者（2.6%）在开始抗 TNF 治疗后出现恶性肿瘤。我们研究人群的恶性肿瘤总发病率为 500.1/100000 患者年，表明发病率高于比利时人群。我们发现女性和男性的发病率都较高；两者的标准化发病率比（SIR）相近（女性为 154.3，男性为 130.6）。
我们发现接受抗 TNF 治疗的 SpA 患者恶性肿瘤发病率呈上升趋势。然而，尚不清楚这种风险增加是与疾病相关还是与治疗相关。
