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Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers
OBJECTIVES: Some studies have reported a possible association between exposure to tumour necrosis factor (TNF) inhibitors and an increased risk of melanoma. The aim of this study was to investigate the incidence of invasive cutaneous melanomas in patients with rheumatoid arthritis (RA) treated with...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5284347/ https://www.ncbi.nlm.nih.gov/pubmed/27307502 http://dx.doi.org/10.1136/annrheumdis-2016-209285 |
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author | Mercer, Louise K Askling, Johan Raaschou, Pauline Dixon, William G Dreyer, Lene Hetland, Merete Lund Strangfeld, Anja Zink, Angela Mariette, Xavier Finckh, Axel Canhao, Helena Iannone, Florenzo Zavada, Jakub Morel, Jacques Gottenberg, Jacques-Eric Hyrich, Kimme L Listing, Joachim |
author_facet | Mercer, Louise K Askling, Johan Raaschou, Pauline Dixon, William G Dreyer, Lene Hetland, Merete Lund Strangfeld, Anja Zink, Angela Mariette, Xavier Finckh, Axel Canhao, Helena Iannone, Florenzo Zavada, Jakub Morel, Jacques Gottenberg, Jacques-Eric Hyrich, Kimme L Listing, Joachim |
author_sort | Mercer, Louise K |
collection | PubMed |
description | OBJECTIVES: Some studies have reported a possible association between exposure to tumour necrosis factor (TNF) inhibitors and an increased risk of melanoma. The aim of this study was to investigate the incidence of invasive cutaneous melanomas in patients with rheumatoid arthritis (RA) treated with TNF inhibitors (TNFi), other biologic disease modifying drugs and non-biologic therapy. METHODS: Eleven biologic registers from nine European countries participated in this collaborative project. According to predefined exposure definitions, cohorts of patients with RA were selected. Using the country-specific general population of each register as reference, age, sex and calendar year standardised incidence ratios (SIRs) of invasive histology-confirmed cutaneous melanoma were calculated within each register. Pooled SIR and incidence rate ratios (IRRs) comparing biologic cohorts to biologic-naïve were calculated across countries by taking the size of the register into account. RESULTS: Overall 130 315 RA patients with a mean age of 58 years contributing 579 983 person-years were available for the analysis and 287 developed a first melanoma. Pooled SIRs for biologic-naïve, TNFi and rituximab-exposed patients were 1.1 (95% CI 0.9 to 1.4), 1.2 (0.99 to 1.6) and 1.3 (0.6 to 2.6), respectively. Incidence rates in tocilizumab and abatacept-exposed patients were also not significantly increased. IRR versus biologic-naïve patients were: TNFi 1.1 (95% CI 0.8 to 1.6); rituximab 1.2 (0.5 to 2.9). CONCLUSIONS: This large European collaborative project did not confirm an overall increased risk of melanoma following exposure to TNFi. |
format | Online Article Text |
id | pubmed-5284347 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-52843472017-02-07 Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers Mercer, Louise K Askling, Johan Raaschou, Pauline Dixon, William G Dreyer, Lene Hetland, Merete Lund Strangfeld, Anja Zink, Angela Mariette, Xavier Finckh, Axel Canhao, Helena Iannone, Florenzo Zavada, Jakub Morel, Jacques Gottenberg, Jacques-Eric Hyrich, Kimme L Listing, Joachim Ann Rheum Dis Clinical and Epidemiological Research OBJECTIVES: Some studies have reported a possible association between exposure to tumour necrosis factor (TNF) inhibitors and an increased risk of melanoma. The aim of this study was to investigate the incidence of invasive cutaneous melanomas in patients with rheumatoid arthritis (RA) treated with TNF inhibitors (TNFi), other biologic disease modifying drugs and non-biologic therapy. METHODS: Eleven biologic registers from nine European countries participated in this collaborative project. According to predefined exposure definitions, cohorts of patients with RA were selected. Using the country-specific general population of each register as reference, age, sex and calendar year standardised incidence ratios (SIRs) of invasive histology-confirmed cutaneous melanoma were calculated within each register. Pooled SIR and incidence rate ratios (IRRs) comparing biologic cohorts to biologic-naïve were calculated across countries by taking the size of the register into account. RESULTS: Overall 130 315 RA patients with a mean age of 58 years contributing 579 983 person-years were available for the analysis and 287 developed a first melanoma. Pooled SIRs for biologic-naïve, TNFi and rituximab-exposed patients were 1.1 (95% CI 0.9 to 1.4), 1.2 (0.99 to 1.6) and 1.3 (0.6 to 2.6), respectively. Incidence rates in tocilizumab and abatacept-exposed patients were also not significantly increased. IRR versus biologic-naïve patients were: TNFi 1.1 (95% CI 0.8 to 1.6); rituximab 1.2 (0.5 to 2.9). CONCLUSIONS: This large European collaborative project did not confirm an overall increased risk of melanoma following exposure to TNFi. BMJ Publishing Group 2017-02 2016-06-15 /pmc/articles/PMC5284347/ /pubmed/27307502 http://dx.doi.org/10.1136/annrheumdis-2016-209285 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Clinical and Epidemiological Research Mercer, Louise K Askling, Johan Raaschou, Pauline Dixon, William G Dreyer, Lene Hetland, Merete Lund Strangfeld, Anja Zink, Angela Mariette, Xavier Finckh, Axel Canhao, Helena Iannone, Florenzo Zavada, Jakub Morel, Jacques Gottenberg, Jacques-Eric Hyrich, Kimme L Listing, Joachim Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers |
title | Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers |
title_full | Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers |
title_fullStr | Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers |
title_full_unstemmed | Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers |
title_short | Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers |
title_sort | risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 european biologic registers |
topic | Clinical and Epidemiological Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5284347/ https://www.ncbi.nlm.nih.gov/pubmed/27307502 http://dx.doi.org/10.1136/annrheumdis-2016-209285 |
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