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Lymphoma in patients treated with anti-TNF. Results of the 3-year prospective French RATIO registry.
Annals of Rheumatic Diseases, 10/22/09
Mariette X et al. – The two to threefold increased risk of lymphoma in patients receiving anti-TNF therapy is similar as that expected for such patients with severe inflammatory diseases. However, some lymphomas associated with immunosuppression may occur, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy.
Methods- National prospective registry (RATIO) from 2004 to 2006
- All cases of lymphoma in French patients receiving anti-TNF therapy, whatever the indication collected
- Case-control analysis including 2 controls treated with anti-TNF per case and an incidence study of lymphoma with French population used as reference
- Collected 38 cases of lymphoma, 31 non-Hodgkin’s lymphoma (NHL) (26 B-cell and 5 T-cell), 5 Hodgkin’s lymphoma (HL) and 2 Hodgkin’s-like lymphoma
- Epstein-Barr virus (EBV) detected in 2 of 2 Hodgkin’s-like lymphoma, 3 of 5 HL and 1 NHL
- Patients receiving adalimumab or infliximab had higher risk than those treated with etanercept: SIR = 4.1 (2.3–7.1) and 3.6 (2.3–5.6) versus 0.9 (0.4–1.8)
- Exposure to adalimumab or infliximab versus etanercept independent risk factor for lymphoma in case-control study: odds ratio=4.7 (1.3–17.7) and 4.1 (1.4–12.5), respectively
- Sex and age- adjusted incidence rate of lymphoma was 42.1 per 100,000 patient-y
- Standardized incidence ratio (SIR) 2.4 (95% confidence interval [CI] 1.7–3.2)
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