Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Anti-TNF Therapy and Malignancy in Spondyloarthropathy-the Leuven Arthritis Biologics Register.
Westhovens, Ine, Lories, Rik, Westhovens, Rene, Verschueren, Patrick, De Vlam, Kurt L.
Tumor necrosis factor alpha (TNF-alpha) is a key member of a large family of cytokines and receptors that are crucial to cellular organization. The use of TNF-alpha antagonists has opened new perspectives for the treatment of patients with spondyloarthropathy (SpA), but concerns are rising about the occurrence of malignancy as a possible adverse event with this kind of therapy.
To report the malignancy incidence in a large single center cohort of patients with SpA treated with one or more anti-TNF therapies and to compare the results with the malignancy incidence in the Belgian population.
From September 2000 until March 2010, all SpA patients starting treatment with one or more anti-TNF therapies were included in this single center retrospective cohort study: 231 patients with a mean age of 47.86 were included for a total of 1020.74 patient years treatment and 1199.83 patient years follow-up after treatment start. 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 2006 for the 4550 year old population, registered by the Belgian Cancer Registry.
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 is 500,1 per 100000 patient years. The incidence rate for malignancy in female SpA patients is more than twice as high as in males (770.1/100000 versus 370.2/100000 patient years respectively), but standardized incidence ratios are in the same range for male and female patients (156.1 for females and 147.8 for males) and indicate a higher incidence of malignancy in our study population compared to the Belgian population.
We see a tendency towards a higher incidence of malignancy in SpA patients treated with anti-TNF therapy. It is still not clear whether this increased risk is disease-related or treatment-related.
To cite this abstract, please use the following information:
Westhovens, Ine, Lories, Rik, Westhovens, Rene, Verschueren, Patrick, De Vlam, Kurt L.; Anti-TNF Therapy and Malignancy in Spondyloarthropathy-the Leuven Arthritis Biologics Register. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1304