Highlights from

EULAR 2019

European Congress of Rheumatology

Madrid 12-15 June 2019

No increased cancer risk for PsA patients on TNF blockers

A population-based cohort study from 4 Nordic countries presented at EULAR 2019 reported that TNF inhibitors (TNFi) do not increase the incidence of cancer in psoriatic arthritis (PsA) patients compared to rates for the general population [1].

PsA is a chronic inflammatory disease that affects the joints, causing pain and disability. TNFi inhibitors have been shown to be efficacious in PsA. However, TNF also plays a role in the development and progression of cancer and therefore, use of TNFi may increase the risk of tumour development.

The current study included over 8,000 TNFi-treated PsA patients from ARTIS (Sweden), DANBIO (Denmark), ICEBIO (Iceland), and ROB-FIN (Finland), contributing a total of 44,041 patient-years of follow-up across all 4 countries. Dr Lene Dreyer et al. (Aalborg University Hospital, Denmark) followed patients from first registration with TNFi-treatment in each country and linked the data to the National Cancer Registry. Patients with a cancer history prior to the start of follow-up were excluded. Cancer rates were compared with standardised general population cancer rates.

There was no increased risk for all cancers or site-specific cancers like lung, colorectal, brain, and breast (see Table). While a significant increase in malignant lymphomas was observed within the trial, it is unclear if this is due to PsA or TNFi-treatment [2].

Table: Standardised incidence ratios of cancer in TNFi-treated PsA patients

Table TNFi

"Our study provides convincing evidence that the use of TNFi does not increase the risk of overall cancer in patients with PsA," said Dr Dreyer. Future studies are needed to assess the observed increase in malignant lymphomas.

  1. Ballegaard C, et al. Abstract OP0005. EULAR 2019

  2. Hellgren K, et al. Ann Rheum Dis 2017;76:105–111

The content and interpretation of these conference highlights are the views and comments of the speakers/authors.